Interoperability is part of COCIR’s DNA. It lies at the heart of our member’s businesses but is also a central piece of the European, national and regional digital health strategies. Everyone in the digital health ecosystem, including policy makers, understands its vital importance but few are able to grasp the steps needed to make it a reality.
“Lack of interoperability is both a reason for, and a result of, market fragmentation. It perpetuates market fragmentation and creates significant barriers to entry, especially for innovators and SMEs." (Blueprint for the Digital Transformation of Health and Care, 2016.) Yet lack of interoperability also presents a major hurdle for advancing the quality and efficiency in European health systems. It prevents data sharing and hinders the ability to maximise the full potential of digital innovation.
This inability to deploy interoperable digital health solutions across European countries remains a barrier to scaling up of integrated care. However, at the same time we see an increasing uptake of mobile health and Internet of Things technologies within the health, social and wellness sectors. Welcome as this trend is, it poses new challenges both for open interoperability and for seamlessly integrating information in a manner that enables delivery of integrated care.
Over the last six years, COCIR has been intensifying communication around the vital importance of adopting international standards. We have worked tirelessly with our partners to accelerate interoperability in the healthcare domain. Achieving interoperability is completely feasible; putting a carefully-planned and well-managed process in place from the outset will smooth uptake. We believe that interoperability should be a step-wise process that can be effectively organised around the following six stages, as described in our publication, “Why Interoperability is Critical to Support Integrated Care in Europe”.
1. Identify use cases from an end-user perspective, describing the proposed eHealth functionality in medical terms (e.g. E-prescription), avoiding using technical language including and including glossary, scenario, actors, privacy requirements and variations.
2. Select profiles and standards that support the selected use case.
3. Refine data content, including document templates, metadata, master files, and terminology.
4. Write interoperability specifications (implementation guides) that describe the standards / profiles selected, the refined data content and other project specific local needs.
5. Organise testing by preparing test cases and adopting a test environment for implementers to demonstrate component interoperability and by organising cross-implementer connectivity testing.
6. Educate end-users on interoperability: Develop communications materials to familiarise end-users on the benefits and impact of Interoperability.
However, a clear process and practical guidance on how to advance in each stage is not enough. The ’bottom-up’ approaches that have been used for many years have proved ineffective in reducing fragmentation. There must also be a top-down approach combined with political leadership expressed at national level. Policy makers need to put eHealth interoperability at the heart of their health policy strategies and make it a personal mission. Digital technologies will only deliver the much-needed transformational changes to our health systems if international standards are widely adopted and supported by politicians at European and national levels. Success needs interoperable IT systems to be in place.
Of course, it is critical to ensure collaborative and joint effort from all stakeholders- including industry - if we want to be successful. However, policy makers hold the key to offering incentives. For example, they could reference relevant standards within procurement processes and public tenders, or build an “interoperability partnership” with their local IT teams, as part of a joint effort to embed this critical element in any health initiative with an IT component.
COCIR is continuing its work closely with IHE and PCHAlliance, further developing specific guidance for policy makers and reinforcing the critical role of these organisations will play in the interoperability landscape. The guidance we are developing builds on the paper we published last year entitled ‘Why Interoperability is Critical to Support Integrated Care in Europe?’
This week, COCIR is taking part in the 2017 IHE Connectathon, Europe’s largest European eHealth testing event. Other key stakeholders present include national and regional government representatives, standards development organisations and healthcare providers.
As we move ever closer to integrated care models and coordinated care , we should not forget that interoperability is critical to providing better, more efficient care. Let’s continue to work closely to make eHealth interoperability the rule, rather than the exception.
More to come soon.
5 April 2017