In this episode

Healthcare interoperability has made enormous leaps in the past five years. So where are we now, and where can we expect to go in the near future? Kathleen Snyder, Sr. Counsel at Husch Blackwell, breaks down the current state of healthcare interoperability in this episode. She covers key advancements, challenges, and predictions for how healthcare interoperability will evolve in 2025 and beyond.

• The evolution of interoperability from isolated to more formalized systems has created significant progress.
• Now, addressing challenges and loopholes is key.
• The future of interoperability: more productive exchange (not just regulation) and expanded data sets.

“I’m a true believer in healthcare interoperability. And for all the players, it’s got to be about getting the right data to the right people, at the right time.

– Kathleen Snyder

Key takeaways

Snyder provided an overview of key interoperability regulations and major phases in the development of interoperability to date. She also provided her takeaways on current interoperability challenges and opportunities to move interoperability forward. Here are some of her major takeaways:

 The evolution of interoperability from isolated to more formalized systems has created significant progress.

Interoperability has been making progress since the 2000s, and Snyder pointed to Executive Order 13335 and the The Health Information Technology for Economic and Clinical Health Act (HITECH) as major early milestones. But she focused on the work done by the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology in the 2020s as key to the current state of healthcare interoperability. In particular, ONC’s Cures Act Final Rule sets the stage for many interoperability regulations today.

“[ASTP has] done a great job at really expanding their footprint to say, we’re not just this weird standalone agency that no one pays attention to. We are the underpinnings for all of our sister HHS agencies. It’s 2025…people need to get on board with interoperability,” she said.

Snyder commended ONC’s HTI-1 final rule, which implements provisions of the 21st Century Cures Act, for addressing AI in healthcare. “I was really impressed with, HTI-1. I thought that it was a really brave move on ONC’s part to take the first step in the federal government towards saying, ‘Healthcare AI is here. How are we going to think through it?'”

Snyder also noted that the entire industry and even patients themselves are more familiar with interoperability and on board with it in the 2020s than in the past: “People are more aware, from a patient perspective. ‘I have the right to access this data, let me access it.'”

Now, addressing challenges and loopholes is key.

With prohibitions on information blocking, “we’re moving toward more formalization [and enforcement instead of] a ‘naughty list’ for those who aren’t complying, where nothing’s really going to happen,” said Snyder. Continued regulation will help “plug up the holes that people were trying to drive Mack trucks through,” she said. “I think that people are doing better [and are] a little bit more cooperative.”

Snyder said that making data exchange simpler and more convenient, especially for patients, is important for the future of interoperability. “Why are you making me print out and carry my images on a CD-ROM?…[and] the fax machine is still a real part of day-to-day business ops,” she said. And the staff workflow is also very manual, she pointed out.

“The number of people that a provider office has to staff to run an office and answer the phones, get the faxes to the right places, scan the PDFs in…it’s a lot of bureaucratic work to collect paper (or virtual paper,” she said.

“I think there’s a real opportunity for innovative companies to come in and say, ‘Let’s help you figure out how to manage your processes and streamline a little bit’…because interoperability is starting to really take hold,” she said.

The future of interoperability: more productive exchange (not just regulation) and expanded data sets.

In addition to streamlining data collection and processes for health systems and patients, Snyder mentioned expanded data sets and more productive exchange as areas where interoperability can continue to grow.

Snyder noted that expanded data in the United States Core Data for Interoperability (USCDI) could make healthcare data exchange more useful for applications like value-based care.

“I think it would be really helpful to be able to expand some of those data elements that we collect — social determinants of health, food insecurity or housing. [For example,] in the case of an elderly patient who doesn’t show up. Is that because they have transportation issues? Or a condition like dementia? …As we really try to give value-based care a go. I think that that would be information that would be helpful for both providers and payers to have available to them, because there are solutions,” she said.

Snyder pointed to buy-in across the healthcare industry as facilitating more productive healthcare data exchange, which she sees as a major evolution of interoperability that will continue in the future.

“Since I got into this space in 2013ish, there have been some really, really rigid rules that have maybe gotten in the way,” she said. “And now, we’re honing in on a collective. The industry has bought in, people have bought in. We’re starting to see better APIs. People are not guarding people are not guarding their [piece of the piece,] but expanding the pie.”

“Let’s try to bring people in, maybe we can break down some of the rigidity. We had to have the rigidity before because there wasn’t enough buy-in, and people were just doing different things. But now, I think it can work. This is my hope.”