Interoperability in Healthcare: What is it and Why Does it Matter

Interoperability in healthcare enables information to flow seamlessly between one system or device to another by breaking down data siloes and creating a universal language between them. Despite its importance for clinical communications and operations, interoperability remains a challenging process to implement for many healthcare organizations. 

Understanding how it works and why it matters is essential to improving patient care, operational efficiency, and compliance within your clinical workflows. 

Below, we’ll discuss why interoperability in healthcare matters, the common challenges providers face, and how interoperable platforms can support and improve clinical communication. 

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What is Interoperability in Healthcare?

Healthcare interoperability is the ability of different healthcare information systems, devices, and applications to access, exchange, integrate, and cooperatively use data in a coordinated way. 

Interoperability is not just about sending data from Point A to Point B, but ensuring that the data can actually be understood and used meaningfully at its destination. It’s essentially about helping each health information system speak the same language. 

There are four levels of interoperability, as defined by The Healthcare Information and Management Systems Society (HIMSS). All four levels must work together for true interoperability. 

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1. Foundational Interoperability

The foundational level of interoperability describes the basic data exchange between systems. At this level, systems can send and receive data, but there's no requirement that the receiving system can interpret or use that data in any meaningful way. 

For example, being able to send lab results over a secure messaging platform using an open API framework. 

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2. Structural Interoperability

Structural interoperability defines the format, syntax, and organization of healthcare data exchange for interpretation. At this level, data formats and structure are standardized so systems can read and organize information consistently.

Systems agree on how to package data so that receiving systems can parse it and identify individual data fields. However, structural interoperability alone doesn't guarantee understanding. 

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3. Semantic Interoperability

Semantic interoperability is where systems not only exchange data but actually understand what that data means. At this level, both the sending and receiving systems interpret data elements the same way, enabling the receiving system to use the data appropriately without human intervention. Essentially, the “meaning” of data is preserved across systems. For example, medication codes being recognized by different EHRs.

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4. Organizational Interoperability

Organizational interoperability addresses the governance, policy, social, legal, and organizational considerations that enable interoperability to function in the real world. 

Even if systems can technically exchange and understand data, organizational factors determine whether and how that exchange actually happens. This level moves beyond technology to address questions such as: 

• Who has permission to access what data? 
• What are the legal agreements governing exchange? 
• How do workflows need to change?

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Why Does Interoperability Matter in Healthcare?

Interoperability isn’t just an important factor for healthcare IT. It directly affects patients, staff, and operations.

In healthcare, interoperability helps ensure data is exchanged and understood in a standardized way. It helps make information accessible and available in the right place at the right time – which is essential for clinical decision making. 

Below are some ways that interoperability can help optimize clinical workflows. 

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1. Patient Safety and Care Quality

Interoperability reduces miscommunication, ensures accurate patient data sharing, and helps providers make timely decisions.

For example, a patient may visit their primary care doctor, then see a specialist, then have lab work done at a third location. Each of these providers may have their own isolated record of care, but without interoperability, none of them can easily see what the others documented. Or, the information isn’t exchanged in a way that they can understand. 

This can create fragmented care, potentially leading to repeated tests, delays in treatment, and even medication errors. 

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2. Reducing Medical Errors

Medical errors are more likely to happen when clinicians lack complete information. In fact, 80% of medical errors stem from miscommunication during patient handoffs. Interoperability can help prevent errors caused by miscommunication by enabling the exchange of critical patient information. 

For example, when a patient arrives at an emergency department, interoperable systems can instantly surface their current medications, allergies, and recent treatments or procedures. Without this background information, a doctor might prescribe a medication the patient is allergic to or that dangerously interacts with their current prescriptions.

Duplicate medications are also a potential risk. If a patient sees multiple specialists who can't access each other's records, they might be prescribed the same drug under different brand names, leading to accidental overdoses. Interoperability creates a single source of truth that prevents these duplications.

The same goes for lab results. If a cardiologist orders a test but the results sit in an isolated system, they might repeat the test unnecessarily or miss an urgent finding. Interoperable systems ensure critical results reach the right clinician at the right time, and abnormal findings can trigger automatic alerts across the care team.

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3. Improving Clinical Workflow 

Clinicians spend a significant amount of time searching for information. A 2016 study found that 59% of doctors' time is spent looking at notes, while 13% was spent searching for paperwork and equipment. 

Spending time looking for the right information can take many forms. From making phone calls and sending faxes, to waiting for records to arrive, or manually re-entering data from paper charts. Each of these steps introduces delays and opportunities for error.

With interoperability, relevant patient information flows automatically to where it's needed, and can be accessed through a single platform. For example, a nurse preparing for a patient visit can see recent specialist notes, upcoming appointments, and medication changes without making a single phone call. This means more time for patient care and less administrative burden.

Interoperability also enables smarter clinical decision support. When systems can share data seamlessly, they can provide real-time alerts about drug interactions, recommend evidence-based treatments based on the patient's complete history, and identify care gaps. These tools only work well when providers have access to comprehensive, up-to-date information.

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4. Enabling Value-Based Care

Value-based care models pay providers based on patient outcomes rather than the volume of services delivered. To succeed in these models, healthcare organizations need to track patient health over time, coordinate care across multiple providers, and identify high-risk patients before they deteriorate and require higher levels of care.

Interoperability makes this possible by creating a longitudinal view of each patient's health journey. As an example, a primary care physician can see when their diabetic patient visited the emergency room, whether they filled their prescriptions, and what their most recent A1C levels were, even if these events happened at different facilities. This visibility allows for proactive interventions.

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Common Challenges in Healthcare Interoperability

The challenges below are why interoperability remains a difficult process to fully understand and implement within healthcare organizations. 

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1. Fragmented Systems and Data Silos

The biggest barrier to establishing seamless interoperability is connecting fragmented systems. 

When your clinical team uses different platforms – such as EHRs, scheduling tools, and communication systems – they don’t naturally “talk” to each other. The data on each system is siloed, making it difficult for clinicians to connect the dots. 

There’s also the matter of inconsistencies in data formatting. For example, some providers may say “blood pressure” while others use “BP.” 

This is a primary reason why semantic interoperability is important. Tools like standardized templates can help create consistency when sharing across different teams or departments. 

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2. Compliance and Regulatory Barriers

Stringent healthcare regulations such as HIPAA and PHIPA sometimes get misinterpreted as blanket prohibitions on sharing. 

For example, HIPAA permits data sharing for treatment, payment, and healthcare operations, as long as it’s being shared on a compliant platform with encryption, access controls, and audit trails. If organizations aren’t using a healthcare compliant platform for its clinical communications – or aren’t sure if their platform is compliant – they may default to using non-compliant methods or manual forms of communication such as paper notes, which can be tricky to communicate with. 

Regional laws add another layer of complexity. Different states and provinces have varying requirements for patient consent, particularly around sensitive information. 

The regulatory landscape is also constantly evolving. New standards emerge, certification requirements change, and enforcement priorities shift. Smaller healthcare organizations may struggle to keep up with these changes while maintaining their existing systems and workflows. 

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3. Outdated Legacy Technology

Legacy systems are pervasive in healthcare. Many hospitals and clinics still run software that's decades old, built before modern interoperability standards existed. These systems might store data in proprietary formats that are difficult to extract in standardized ways. Upgrading or replacing them can be expensive and disruptive.

The cost barrier can be substantial, particularly for smaller practices and rural hospitals that may be strapped for resources. Implementing interoperable systems requires not just software purchases but also infrastructure upgrades, staff training and adoption, workflow redesign, and ongoing maintenance. Many organizations may be hesitant about the upfront investment, even if the solution is cost-effective in the long-term.

There's also the challenge of insufficient technical expertise. Healthcare IT requires specialized knowledge that's in short supply. Many organizations lack staff who understand both clinical workflows and modern interoperability standards, making it difficult to design and implement effective solutions without support. 

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Interoperability Standards and Regulations

To help your organization set up an interoperable system, it’s important to understand the standards and regulations that you must adhere to. These standards set the framework for how systems communicate with each other by standardizing messaging and terminology, as well as providing governance that ensures interoperability. 

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What are some US Interoperability Standards?

• FHIR (Fast Healthcare Interoperability Resources): Developed by HL7 International, FHIR is the standard for exchanging healthcare information electronically. 
• HL7: HL7 International has also developed HL7 v2, a healthcare messaging standard that allows the exchange of clinical data between systems. It’s designed to support a central patient care system as well as a more distributed environment where data resides in departmental systems.
• SNOMED CT: The Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) provides standardized, multi-lingual medical terminology that’s used for the electronic exchange of clinical health information. 
• USCDI: The United States Core Data for Interoperability (USCDI) a standardized set of health data classes and constituent data elements for nationwide, interoperable health information exchange. 
• TEFCA: The Trusted Exchange Framework and Common Agreement provides governance by setting the rules and trust framework for nationwide exchange of electronic health information. 

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What are some Canadian Interoperability Standards?

• Pan-Canadian Patient Summary (PS-CA): A core set of essential health information that should be immediately available wherever a patient receives care. It's based on the International Patient Summary (IPS) developed by international standards organizations, but adapted specifically for the Canadian context.
• SNOMED CT Canadian Edition: The Canadian Edition includes all the core SNOMED CT content mentioned above, but is created with Canadian-preferred terms. For example, it may specify Canadian English or French terminology preferences. 

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Real-World Examples and Use Cases of Interoperability in Healthcare

Below are examples of how clinical communication platforms with interoperable features can yield measurable improvements for clinical workflows and communication. 

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1. Unified Communication Platforms

Hypercare enables cross-system communication by seamlessly enabling integration of EHRs, scheduling tools, and paging systems. A unified communication platform like Hypercare accelerates time to care with secure messaging, mobile alerts and on-call visibility, designed for the fast-paced realities of healthcare delivery.

For example, Huron Perth Healthcare Alliance (HPHA), a multi-site healthcare system, sought to unify its fragmented communication systems which included pagers, paper schedules, and multiple switchboards. The hospital knew it needed an interoperable, all-in-one solution to integrate its clinical workflow. 

HPHA chose Hypercare for how seamlessly the different functions of the app meshed together with real clinical workflows. After a successful deployment, the hospital is continuing to look for ways to implement Hypercare’s interoperable features within its communication systems. This includes formalizing a verbal order verification system to reduce the likelihood of medication errors, and building templated messages will allow for smoother and more structured communication.

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2. Faster Team Activations

Integrated tools like Hypercare help reduce code team activation time from minutes to seconds. 

For example, Mile Bluff Medical Center used Hypercare’s interoperable platform to implement and connect real-time scheduling, messaging, and surgical activation workflows across its organization. 

As a result of its improved clinical workflow, Mile Bluff’s activation time for urgent and emergency surgeries dropped from 20-30 minutes to just five seconds.

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3. Scheduling and Messaging Integration

Interoperability is also essential for syncing on-call scheduling with secure messaging as it can improve response rates, eliminate time searching for the right provider, and reduce delays in care. 

At Sault Area Hospital (SAH), using Hypercare’s integrated communications platform was key to improving how physicians coordinate and communicate. Connecting scheduling with secure messaging offered real-time visibility into who was on call and enabled faster, easier coordination. Physicians at SAH also rely on Hypercare as a live directory, reducing reliance on switchboard operators.

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Interoperability vs Integration: What’s the Difference?

Integration is about connecting specific systems together, usually within a single organization. For example, a hospital might integrate its EHR system with its laboratory system so that when a lab result is finalized, it automatically appears in the patient's chart. This integration is custom-built for these two specific systems, often using proprietary interfaces or middleware.

Interoperability is about enabling systems to exchange and use data across organizational boundaries using standardized methods. It's not just about connecting System A to System B, it's about creating a common framework where any compliant system can communicate with any other compliant system without custom configuration.

For example, when call schedules are updated in a scheduling system, an interoperable platform interprets that data and routes messages accordingly, so clinicians don’t have to spend time searching for contact information. 

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How Interoperability Supports Clinical Communication

Clinical communication without interoperability is like trying to coordinate a complex surgery where every team member uses different tools, terminology, and methods – making it difficult to get on the same page. Interoperability provides the common language and shared workspace that makes coordinated care possible.

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1. Seamless Workflows

Interoperability transforms clinical communication from a manual, disconnected process into an integrated flow. Think about a typical patient care scenario: a primary care physician needs to consult with a cardiologist about a patient with chest pain. Without interoperability, this involves phone tag, faxing records, manually reviewing documents, and then calling back with recommendations – all while the clinical context lives in different systems.

With interoperability supporting clinical communication, the workflow becomes seamless. The primary care physician sends a consultation request directly from their EHR, and the patient's relevant history, recent test results, medications, and vital signs automatically populate the cardiologist's system. The cardiologist reviews everything in context, adds their recommendations directly into a shared care plan, and the primary care physician receives an alert that the consultation is complete – all without leaving their respective systems.

Real-time communication is another critical element impacted by interoperability. When a patient's condition changes, interoperable systems can push notifications to all relevant team members simultaneously. A sudden drop in blood pressure doesn't just sit in one system waiting to be noticed. Instead, it triggers alerts across the care team's communication channels, enabling rapid coordinated response.

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2. Secure and Compliant Messaging

Interoperability enables secure messaging platforms that work across organizational boundaries while maintaining HIPAA compliance. 

With secure messaging platforms, a physician can securely message a specialist knowing the messages are encrypted, authenticated, and create an audit trail. This communication flow meets regulatory requirements while being as convenient as consumer messaging apps.

Interoperable systems can also help provide more context for secure messages. For example, Hypercare’s secure messaging platform enables clinicians to share rich patient data, such as lab results or images. This helps the receiver get critical context without switching to another system or dealing with login hurdles.

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3. On-Call Scheduling and Contact Directory

Directory services become more powerful with interoperability. Finding the right person to communicate with – whether a provider needs to know which cardiologist is on call, which nurse is assigned to a patient, or which specialist has availability – requires shared, live directories that work across systems. 

Interoperable directories sync with other systems your hospital uses, such as single sign-on and directory systems. This enables clinicians to search their organization once and find the correct provider and their contact information. 

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4. Data-Driven Improvements

When communication data flows through interoperable systems, it becomes analyzable in ways that drive continuous improvement.

For example, a clinical communications platform with built-in analytics can surface insights such as response time, which can reveal bottlenecks. Healthcare organizations can track how long it takes for consult requests to be acknowledged, urgent messages to be read, or test results to be reviewed. 

When this data is standardized across systems through interoperability, you can benchmark performance, identify delays, and intervene before they impact patient care. 

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Healthcare Interoperability: Key Takeaways

Interoperability is critical for healthcare organizations to function as a cohesive system rather than a collection of disconnected parts. When information flows freely and intelligently across the care continuum, clinicians have the right information needed for decision making. This allows providers to focus on caregiving rather than information gathering, which ultimately improves patient outcomes.

Healthcare organizations that invest in interoperable platforms like Hypercare aren't just ensuring compliance, they're building the infrastructure for sustainable, high-quality care that benefits clinical teams and patients. To learn how Hypercare can improve interoperability at your organization, book a demo.