Interoperability in Hospitals

• Joanna Chelimala, Senior Product Manager e-Invoicing

Although the NHS Digital’s Interoperability Toolkit and the Global Digital Exemplar Programme were launched years ago, hospitals have been hampered by crises and limited resources in achieving seamless data flows. Yet the benefits of interoperable processes in hospitals are immense. By establishing seamless data flows and promoting interoperability, healthcare providers can reduce costs, increase transparency and improve patient care.

In recent years, the UK’s National Health Service (NHS) has undergone significant modernisation. Despite the daunting backlogs following the pandemic, the merits of the new NHS applications are widely recognised. These have been introduced as part of NHS Digital’s Interoperability Toolkit and the Global Digital Exemplar Programme. Moreover, it is reassuring that patient data is being securely stored and shared across trusts. No matter where patients receive treatment, their records are always accessible, thanks to the Local Health and Care Record Exemplars initiative.

The digitalisation era has indeed commenced for the NHS, but what is its future direction?

I am not divulging any secrets when I say that efficient, digital, and structured data exchange in healthcare can significantly ease the burden for all involved parties. Yet, it is clear that we still need to achieve the ideal of seamless data flow. The coronavirus pandemic has highlighted how limited our insight into health data remains. The challenge lies not in the absence of data or the willingness to utilise it but in the need for robust structures and standards that facilitate seamless and secure data exchange.

What does Interoperability mean?

Before I delve into how healthcare providers can accomplish interoperable data exchange, it is pertinent to define what interoperability actually entails. According to the European Medical Devices Regulation, interoperability means “the ability of two or more products - including software - from the same manufacturer or from different manufacturers to exchange information and to use the exchanged information to perform a specific function correctly without changing the content of the data”.

What may appear logical is, in fact, highly complex in the healthcare sector. The reason lies in the fact that hospitals operate with a multitude of systems that are independent of one another and supplied by various manufacturers, each with its own unique data structures. ERP systems, software for financial accounting or communication within the wards, and scanner solutions for orders or inventory management all contribute to a scenario where, in most hospitals, the IT infrastructure resembles an archipelago rather than a unified system.

How can Hospitals Benefit from Interoperable Processes?

The homogeneity and harmonisation of systems can only be achieved by embracing standards. Analysing which departments, hospitals and standards are affected across the integrated care system (ICS) is a complex matter but one that pays off in the long term. A comprehensive overview of the benefits of interoperability and the rationale behind it is provided by a Deloitte study, which specifically addresses the healthcare environment.

The analysis emphasises how the healthcare industry should measure the return on investment (ROI) to make it worthwhile and relevant. The right approach should lead to:

1. Decrease in administrative expenses as manual procurement tasks are streamlined or automated with technology.
2. Enhanced efficiency in care delivery as providers use technology to treat patients more effectively through a cohesive care model that includes virtual settings.
3. Lower overall healthcare costs through more efficient population health management strategies that employ technology to reduce both costs per unit and overall usage rates.
4. Improved patient experience and more effective clinical pathways.

Tips for Implementing Interoperable Processes

Interoperability is fundamentally a technical matter that will preoccupy hospital IT departments. However, it also represents a paradigm shift in a healthcare organisation’s culture. It is essential for those in charge to realise that the seamless exchange of data and cross-departmental information usage are vital for digital transformation. Interoperability, therefore, requires a radical reorientation in almost all departments. Realising the benefits can strongly drive that change.

The question remains: where and how do hospitals start to recognise and implement interoperability effectively?

Let’s start with the clear goal - the administrative cost reduction. Interoperability offers the potential to reduce administrative costs significantly within healthcare organisations. By enabling healthcare providers to streamline their operations, interoperability can minimise or reallocate full-time employee (FTE) hours away from labour-intensive, low-value manual tasks. Instead, these resources can be directed towards activities that decrease healthcare costs and enhance the quality of care. This strategic shift optimises workforce efficiency, contributes to the overall improvement of healthcare services, and delivers more fulfilling and challenging tasks to the workforce. It is truly a win-win situation, with the entire integrated care system and patient in mind.

Interoperable Processes as a Foundation for Value-Based Healthcare

The other way of looking at the change that interoperability requirements would drive is the data management improvements. Interoperability greatly enhances the efficiency of healthcare delivery by giving clinicians access to real-time or near-real-time data across various care settings. This advanced accessibility changes the dynamics of where and how care is provided and expands the scope of who can deliver care. As a result, more patients can be treated promptly and efficiently. By transforming the delivery processes, interoperability allows for more flexible, patient-centric healthcare services, potentially leading to improved outcomes and greater patient satisfaction.

Furthermore, reducing the total cost of care has always been a priority for integrated care systems (ICSs). Still, providers operating under value-based healthcare (VBH) reimbursement models are similarly motivated to minimise healthcare service usage. Interoperability plays a crucial role by providing capabilities that both ICSs and providers can use to enhance patient outcomes. This improvement in quality of care benefits patients and drives better financial results in a VBH framework, demonstrating how strategic use of interoperable systems can lead to more efficient delivery of care.

Advantages of Interoperability in the Healthcare Sector

Introducing interoperable processes may initially seem daunting, but the long-term benefits are significant. Seamless data flow and utilisation within an organisation and across the industry yield substantial advantages, such as:

• Relief for clinical staff through the simplification of daily routines.
• Enhanced transparency in purchasing, storage, logistics, and consumption of medical products and consumables.
• Optimisation of the ordering process and inventory management, including strategies like consignment.
• Cost reductions are achieved by streamlining process costs.
• Sustainable management practices that minimise waste, such as tracking expiry dates of supplies.
• Personalised care that enhances the patient experience, exemplified by the use of digital patient records.
• Simplified networking with external partners such as system service providers, public institutions, agencies, and other healthcare organisations.
• Improved digital safety with interconnected databases containing procurement, hospital inventory, and patient implant data.
• Enhanced clinical outcomes through improved management and analysis of clinical data.

These not only enhance operational efficiency but can also significantly contribute to improved patient care and resource management.

Ultimately, interoperable, data-driven solutions refine processes within the organisation and elevate patient care to a new level over the long term. By integrating system landscapes both within and beyond the organisation, these solutions enhance communication among specialised departments for more effective treatment. Additionally, they enable patients to receive prompt, well-informed, and targeted care with reduced delays.

Interoperability and Digital Supply Chain Processes

To ensure that patients receive the highest standard of care, it is essential that medical supplies are delivered promptly and accurately where needed. Robust and automated supply chain processes within interoperable IT environments underpin this. These processes depend on healthcare providers and suppliers utilising digital solutions for the transfer of structured business documents and adhering to shared technical standards.

Traditional methods, such as fax or email orders and PDF invoices, lack structured data, hindering integration into other systems without manual intervention. Exchanges between healthcare providers and suppliers must occur in structured electronic formats for swift and automated processing of orders, order acknowledgements, advance ship notices, and invoices. Utilising real-time data allows healthcare organisations to monitor the status of their orders continuously, which is particularly crucial during periods of supply chain disruption. This helps to ensure efficiency and enhances the reliability of medical supply delivery in critical times.

Making Interoperability a Top Priority

As we move toward the future, hospitals must focus on their digital transformation and ensure they can work smoothly across their systems. Given the legislative drive around the e-invoicing mandates, it would be imprudent financially to overlook the chance to embrace interoperable IT systems immediately.

Furthermore, the procurement process in the healthcare sector, which is crucial for the exchange of business documents between providers and suppliers, ought to be a key focus for healthcare organisations. This is not only a legislative need but also a strategic move to streamline operations, cut costs, alleviate staff burdens, and refocus on the primary concern: patient care.

Do you want to learn more about implementing interoperable processes in your organisation? Please do not hesitate to contact our experts if you have any questions.

Joanna Chelimala

Senior Product Manager e-Invoicing

Joanna Chelimala, the Senior Product Manager of e-Invoicing at GHX Europe, is a seasoned expert in compliant e-invoicing and interoperability strategy. With a wealth of experience and a deep understanding of the healthcare industry, she is dedicated to delivering world-class products and feature enhancements that support the success of healthcare organisations.