Even now that the EMR is in widespread use, nurses still spend a lot of time on patient charting. That makes them primary stakeholders in electronic records and puts them in a prime position to care that EMR systems have not yet reached the optimum level of usability. One reason for this is that healthcare has not made enough progress with interoperability standards.
Interoperability refers to the ways in which different systems and devices can share data and present that data to the end user. For two systems to be interoperable, they have to be able to communicate with each other to exchange data, as well as interpret the electronic data so it can be presented in an appropriate format. In healthcare, data should ideally be shareable across organizations that include physician offices, hospitals, laboratories, pharmacies, and patient portals. Within a single organization, data should be shareable between clinical systems and financial (billing) systems.
Yet there are barriers to interoperability. Early EMR systems were developed by various vendors in different formats, designed to function as standalone systems within one healthcare facility. Thirty years ago, technology vendors had an incentive to stick with proprietary data formats, to lock in their customers and make it inconvenient for them to change systems. Today, the opposite is true, and there are incentives to adopt standards that work across different systems.
Yet interoperability remains a complicated issue for many reasons, including the need to maintain HIPAA compliance and patient privacy. There are now ongoing efforts to standardize these aspects of healthcare information technology:
- Terminology—through standardized healthcare vocabularies like ICD-10 codes that describe medical conditions and treatments. ICD-10 was designed to be an improvement over ICD-9, and it includes nearly 150,000 codes that cover nearly all possible diseases and types of injuries.
- Structure—through a common framework like Health Level 7 (HL7) that ensures data can be interpreted by the system or device that receives it from another health system or device. HL7 has created standards for how lab results are reported and patient data is exchanged.
- Transmission—through secure email and messaging protocols that ensure patient privacy while data is being transmitted.
- Security—through standardized encryption methods that prevent unauthorized access to patient data on the devices with which it is stored and accessed, while allowing data to be shared and interpreted by systems and devices that receive it.
So why should nurses care about interoperability? Nurses are frontline care givers and patient advocates. When they have relevant, timely information about their patients, they can provide the highest quality patient care. But beyond this, the way patient data (including physician orders, lab results, etc.) is presented can affect nursing workflows. When nurses provide input on how the EMR is designed and used, nurses can ensure that procedures and workflows are truly patient-centric.
If you’re a tech-savvy nurse with an interest in the way the EMR affects quality of care, why not consider specializing in nursing informatics? Healthcare is in need of nurses who can analyze technologies from both the bedside and IT perspectives. An online MSN degree in nursing informatics is the perfect way to improve your knowledge, skills, and value to your organization.