Educational Material

[Article] Data Interoperability and its challenges in the hospital environment

1 – What is data interoperability in healthcare?

Data interoperability in healthcare refers to the ability of different systems and devices to exchange, understand, and use information in a coordinated and effective manner. It includes the data exchange among hospitals, clinics, laboratories, and pharmacies, among other healthcare points, as well as the integration of data among different medical devices and information management systems.

Data interoperability in healthcare became of paramount importance to improve the quality of healthcare, patient safety, and the efficiency of healthcare systems. Nonetheless, reaching full interoperability requires overcoming substantial challenges related to standards, security, data quality, costs, and resistance to change.

In this scenario, cooperation among governments, healthcare institutions, and technology providers is of the essence to address these challenges and promote the benefits of interoperability. In this article, we will outline the main difficulties in adopting data interoperability in healthcare.

2 – Challenges of data interoperability in healthcare (data standardization, laws, and technologies)

The biggest challenges of data interoperability in healthcare involve technical, organizational, and regulatory issues that make it difficult to exchange and efficiently use information among different healthcare systems and organizations. Below are some of the main challenges:

1. Inconsistent data standards

One of the main reasons for the difficulty in implementing interoperability in a large mass of data in healthcare institutions is data standardization.
There are three types of interoperability:

• Syntactic interoperability: Focuses on data structure. It ensures that data exchanged among systems uses compatible formats, such as XML or JSON;
• Semantic interoperability: Focuses on the meaning of the data. It ensures that exchanged information has the same meaning across different systems, using common terminology and standards, such as SNOMED CT or LOINC;
• Organizational interoperability: It involves policies, processes, and legal requirements that ease the data exchange and use among different entities.

Currently, there are several data standards and formats used by different systems, such as HL7 v2, HL7 FHIR, and DICOM, among others. The lack of a universal standard makes the integration process difficult, as each healthcare institution can use what suits it best.

2. Laws and regulations

Different countries and even different states within the same country, as is the case in the United States (CCPA, HIPAA, etc.), may have different regulations on privacy and healthcare data protection. This variation in data privacy laws makes it difficult to exchange information across borders, considering each country or state may use clinical formats or libraries as needed.

In the European Union, e.g., the GDPR (General Data Protection Regulation) imposes strict requirements on the storage and processing of personal data, including healthcare data. In Brazil, the LGPD (Lei Geral de Proteção de Dados) regulates this entire process. This regulation diversity becomes a complicating factor in the implementation and creation of interoperable systems that can be used uniformly in different regions.

Another essential aspect is the lack of standardized rules on the healthcare data exchange among different systems and jurisdictions. The creation of different disease and treatment coding systems, such as ICD-10, ICD-11, SNOMED CT, and LOINC, are used in different regions, making interoperability difficult.

Overcoming these challenges requires a coordinated effort among governments, healthcare organizations, and technology providers to correspond regulations, simplify compliance requirements, and promote the adoption of global standards.

3. Costs and complexity

Implementing interoperability solutions can be expensive in some regions and technically complex, requiring investment in new technologies and staff training. For example, small clinics and hospitals may not have the human and financial resources to adopt new interoperable technologies.

4. Fragmentation of healthcare systems

The fragmentation of healthcare systems is one of the most critical challenges for data interoperability in healthcare and can occur in several dimensions, such as technology, processes, and organizational infrastructure.

For example: The lack of compatibility among systems prevents the smooth exchange of healthcare data among different institutions, making it difficult to create a unified medical record for patients. This occurs when the hospital uses a vendor’s electronic health record (EHR) system, but the clinic (whether imaging studies, specialty, or other) uses a different EHR, resulting in communication difficulties.

A possible solution to this situation would be the development of interoperable networks and platforms that allow communication among different systems, using APIs and other integration technologies.

3 – Conclusion

It is common knowledge that data interoperability in healthcare brings countless benefits to patient care and treatment, delivering greater security and efficiency to processes in healthcare systems. However, these standards, legislation, costs, and complexities difference make it difficult to exchange data and information among healthcare institutions.

As we have noted, overcoming these challenges requires a coordinated effort among governments, healthcare organizations, and technology providers to correspond regulations, simplify compliance requirements, and promote the adoption of global standards to overcome the financial and technical obstacles to data interoperability in healthcare.

Once these challenges are settled, meeting and fully exploiting the potential of interoperability in the global healthcare scenario will be possible.

Epimed Solutions works every day to mitigate these challenges as much as possible, providing its clients with highly complex technologies capable of transferring data with different hospital, laboratory, and administrative systems. Furthermore, Epimed is fully adapted and adjusted to the practices imposed by the laws of each of the 11 countries where it is currently present.