Federal health data officials called to view health information interoperability as a journey to be developed with end users and iterated over time rather than a major destination to reach all at once during last week’s Academy Health Datapalooza virtual conference.
Furthermore, interoperability is best achieved when the federal government articulates and defines data standards over time alongside partners.
“Government, working with industry and working with academia, working with people on the front lines of the reporting, and then together figuring out how to report that data in the most useful way — then the role we can play is to say these are the standards and help industry developers and all sectors to adopt them in a consistent way,” said Kristen Honey, senior advisor to the assistant secretary for health and executive director of data operations at the Department of Health and Human Services.
Centers for Disease Control and Prevention Chief Data Officer Alan Sim emphasized that also being agile and intentional in what to make interoperable at first are critical.
“Organizations can't wait for long extended periods of times for the standards to be defined and implemented — so really understanding the use cases, electronic case reporting, electronic lab reporting, being agile in the way that we try to implement different standards as proof of concepts, learning from those experiences,” Sim said. “Over time we have change management, and we can begin disseminating those lessons learned, so we can have more of an infrastructure from a standardization perspective.”
There are also a variety of interoperability standards that are out there, from application program interfaces (APIs) to Fast Healthcare Interoperability Resources (FHIR). To properly iterate in a meaningful way, it’s important to consider specific use cases along the way.
“We have to be thoughtful about the various use cases and recognize that each use case has a different timeline and try to balance that,” Sim said. “We’re definitely in a new era, and we’re having to be very responsive.”
With critical use cases, like Sim said, it’s easier to to focus on what standards are best for a given scenario, said Greg Singleton, director of the Health Sector Cybersecurity Coordination Center, HHS' cyber threat center. He used COVID-19 as an example for how HHS was able to connect data systems across over 6,000 different hospitals in the country to gather and consolidate information about the pandemic from those institutions.
“What it took was a national, global pandemic emergency to say, ‘Oh boy, we can do this,'" Sim said.
Honey added that amid all the challenges of trying to break down silos preventing interoperability, finding a common problem for everyone to work on together like COVID-19, and leadership prioritization of interoperability have been particularly powerful recently.
“COVID right now is the ultimate challenge,” Honey said. “I’ve watched silos crumble as we harness the resources needed, shared information across historical, conventional boundaries. And then the other element that I think is so important for breaking through silos is leadership, and the leadership starts at the very top."