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If you’ve heard of “interoperability” and wondered what it means, this primer will give you a better understanding of what it means, its benefits and the challenges associated with implementation.

A doctor checks the blood pressure of an elderly patient in a bright medical office

What is healthcare interoperability?

Healthcare interoperability refers to the ability of different health information systems, devices or applications to connect and exchange data in a seamless manner.

By ensuring critical patient information flows easily to healthcare providers, interoperability enables physicians to provide the best possible care.

What are the benefits of interoperability for members?

By providing easy access to patient data, interoperability solutions boost provider efficiency and lessen the administrative burden, giving physicians more time to focus on patients.

When providers get more timely information, there are fewer care delays. The result is a better overall patient experience at the point of care and the potential for better health outcomes.

Interoperability solutions also play a role in helping to facilitate preventive care. Humana shares information that enables providers to be proactive when delivering care—for example, which patients are due for a colonoscopy or a mammogram, along with other information that keeps providers up to date on their patients’ medical status. This information shows up for providers as a point-of-care alert—one of Humana’s interoperability solutions.

What are the challenges to implementing interoperability?

True interoperability is only possible when all stakeholders agree on the standards, technologies and terminology for exchanging data between disparate systems. Challenges can include:

  • Inconsistent data and lack of standardized data structure: Data residing in different databases often comes in various formats that may not be compatible.
  • Patient privacy and security: Systems and solutions must ensure patients’ private information is protected.
  • Lack of standards: There is currently no universal healthcare interoperability standard for all providers across the country.
  • Vendor lock-in: Some vendors use proprietary software—this limits data exchange with competing platforms.
  • Regulatory complexity: While regulations are necessary to protect data, they can also discourage data sharing by imposing strict compliance requirements.

What are some interoperability solutions?

  • Medical authorization helps speed up the authorization process.
  • Point-of-care alerts automate insights for patient care opportunities.
  • Medical record retrieval enables a reduction in medical request letters.
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To learn more, visit Humana Group Medicare
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