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Interoperability is the technical term for the ability an information technology sector or section to speak to and communicate with another information technology sector or section exclusive of intervention from the end user  This feature is useful and necessary in electronic health or medical record communications. Advancements in the delivery and usage of medical care will also increase utilization of interoperability.


 * Contents


 * Chronology of Interoperability within Electronic Medical Records (National Electronic Health records)


 * Levels of Interoperability within Electronic Medical Records


 * Challenges of Interoperability within EMR’s


 * Advancements of Interoperability within EMR’s


 * See Also


 * References


 * External Links


 * Chronology of Interoperability within Electronic Medical Records (National Electronic Health records)

The healthcare model provided by the Department of Defense and the Veteran’s Administration was a good candidate to create a national electronic health record interoperability plan. The initiative for a EHR interoperability first began in 2000. It was a gateway for the 2004 Executive Order for a nationwide interoperability infrastructure for almost all American citizens to have an interoperable EHR by the year 2014. In 2001, the Office of Management and Budget (OMB) e-government project to provide federal groups the ability to develop data systems that were interoperable. After the Executive Order was instituted in 2004, the Office of the National Coordinator for Health Information Technology (ONCHIT) under the guidance of the Department of Health and Human Services was founded. The intent of this office was to create the implementation plan for a nationwide interoperable system. As a result of ONCHIT, four other organizations were also identified as key players in nationwide interoperability :

-	American Health Information Community (AHIC)

-	Health Information Technology Standards Panel (HITSP),

-	Nationwide health Information Network (NHIN),

-	Certification Commission for Health Information Technology (CCHIT).

AHIC & HITSP are two organizations formed in 2005, which are integral parts of nationwide interoperability. The AHIC has a combination of individuals from the private and public sectors. They role is to create use cases to demonstrate the function of specific tasks to progress the interoperability movement. The HITSP is a private non-profit organization who strives for unison and harmony of IT standards. Later that year, the CCHIT was commission to establish criteria to certify health IT products. One of the key requirements for certification is meeting the government standards for interoperability. The Nationwide Health Information Network (NHIN) is the secure, information infrastructure that will link all participants of healthcare aspects. The NHIN is the framework that will permit the availability of the health information.


 * Levels of Interoperability within Electronic Medical Records

Interoperability within healthcare can be reached at varying levels. The levels are:

-	Non-electronic Data

-	Unstructured, viewable electronic data

-	Structured, viewable electronic data

-	Computable, electronic data

At the lowest level are paper medical records. These documents are classified as interoperable as they can be read by human beings. This is the non-electronic data level. Scanned documents such as a patient progress record would reach the second level of interoperability in which physicians would need to evaluate unorganized, electronic data. The next level would contain textual information. The top level of interoperability is achieved when the information evaluated is standardized in a complete, electronic format.


 * Challenges of Interoperability within EMR’s

Multiple electronic medical record formats prevent a single EMR leader to emerge. This lack of leadership inhibits the use of a single EMR source. Government mandated legislation such as the HITECH Act of 2009 required that providers demonstrate meaningful use of EMR’s to be eligible for financial incentives. This process is one of the three components for meaningful use. As the second component, providers and facilities demonstrate the electronic exchange of health information to improve the quality of care delivered.

EMR have been developed in different programming languages for the coding of the software. C++ or Visual Basic based languages are system dependent and enabling these structures to work with other systems proves challenging. Another challenge is the delivery of health information to other systems such as insurance verification systems, claims submission, electronic pharmacy applications, computerized order entry and interfaces with other national payer platforms. This would require a large scale of interoperable systems that would go across the county. Data architecture as well as infrastructure problems lead to the pitfalls of interoperability within EMR systems.


 * Advancements of Interoperability within EMR’s

The establishment of the Health Level Seven or HL7 framework assists in the interoperability of electronic medical records. HL7 is the set of standards which is used to exchange and share health information. Another advancement is the utilization of permitting multiple integration methods. Medical records interoperability can occur through vendor chosen networks or through third party gateways. One of the most significant advances occurs within the Office of the Coordinator for Health Information Technology (HITONC). They have developed an automated test to determine if types of EHR software can securely send EHR data from state to state. This single effort is a milestone achievement for the national health information exchange as its passing would permit a significant number of physicians to gain necessary access to health information for patients in participating health information exchanges.


 * See Also

EMR


 * References


 * 1) External Links


 * 1) http://srssoft.com/mostashari-says-obama-can-thank-data-analytics-for-victory


 * 1) http://www.medpagetoday.com/PracticeManagement/InformationTechnology/35113