Interoperability: Cross-System Data Exchange In Healthcare

The purpose of this article is to describe the significance of interoperability in healthcare information technology, as well as some techniques for ensuring its seamless and efficient deployment. It also mentions “Arihant Information Systems” experience developing healthcare apps. It is worthy of your attention whether you are a healthcare company.

In this era of digital healthcare transformation, the ability to transfer data across various systems efficiently and securely is not just an advantage’s a necessity. Drawing from my 16 years of experience in healthcare IT, this blog offers a comprehensive exploration of the complexities of cross-system data transfers. We will delve into essential standards like HL7, FHIR, and DICOM, navigate through vital protocols such as RESTful APIs and Secure FTP, and unpack best practices that ensure data integrity, security, and compliance.

This post is intended for healthcare professionals and IT professionals who want to learn more about data transfer techniques and improve the performance of their systems. By the conclusion, you’ll have gained knowledge about creating robust, scalable, and adaptable data transfer systems that are ready to handle the changing demands of healthcare IT.

What Does Interoperability Mean?

Drawing upon my 16 years of experience in software development within the healthcare IT sector, I’ve come to understand interoperability as the seamless synergy between various hardware and software entities – encompassing applications, databases, and other computer systems. These diverse systems cannot only connect and communicate with each other but also effectively exchange and mutually interpret data. This process transforms raw data into meaningful information that can be utilized across platforms, enhancing the functionality and efficiency of healthcare IT solutions.

I’ve observed that within the healthcare domain, interoperability takes on a critical role. It embodies the capacity of health information systems, devices, and applications to seamlessly interconnect, both within and beyond the boundaries of a healthcare organization. This encompasses the secure and efficient exchange and utilization of vital patient data and other pertinent information. Such information ranges from admission and discharge records to transfer notifications, laboratory and examination results, and even detailed filed claims. This interconnectedness and fluid data exchange are fundamental in enhancing the efficiency and effectiveness of healthcare services.

Cross-System Data Exchange: The Backbone of Modern Healthcare IT

The key component of healthcare IT is its capacity to reliably and efficiently move patient data between various systems. This improves operational efficiency and raises the standard of care.

Navigating the many standards and protocols that control this data transmission is hard, though.

Understanding the Standards: HL7, FHIR, and DICOM

Let’s delve deeper into the standards of HL7, FHIR, and DICOM, which are pivotal in healthcare IT for cross-system data transfer. Each of these standards serves a specific purpose and has its own set of use cases, which I will explain with examples for added clarity.

1. HL7 (Health Level 7)
   • HL7 refers to a set of international standards for the exchange of clinical and administrative data in healthcare. It’s designed to streamline the process so different systems can understand and interpret the data being exchanged.
   • HL7 messages are encoded in a specific format, with fields and segments (each on a distinct line) separated by delimiters. An HL7 message including patient information, for example, would typically begin with an MSH (Message Header) segment and proceed to include PID (Patient Identification) and PV1 (Patient Visit) segments.
   • Consider the following scenario: A patient visits a clinic. When a patient is registered, the clinic’s system generates an HL7, ADT (Admission, Discharge, Transfer) message. This message contains information such as patient identification, visit information, and insurance information. When data is sent to a hospital information system, the system interprets it for further processing, such as appointment scheduling or updating medical records.
2. FHIR (Fast Healthcare Interoperability Resources)
   • A more recent standard called FHIR was created by HL7 with interoperability and ease of use in mind. It works especially well with cloud communications, mobile devices, and the web.
   • FHIR makes use of contemporary web technologies like XML, JSON, and RESTful APIs. It organizes data into basic units called “resources” that can be joined to create complex healthcare data representations. A ‘Patient’ resource in FHIR, for example, may include attributes like name, gender, and birthdate.
   • Consider a telemedicine app that needs to retrieve a patient’s medical history from a hospital’s electronic health record (EHR) system. Using FHIR, the app can send a RESTful query to the EHR’s FHIR server to retrieve the ‘Patient’ resource. This query would return structured data (such as JSON) containing the patient’s medical history, which the app could then display.
3. DICOM (Digital Imaging and Communications in Medicine)
   • DICOM is the international medical imaging standard. It is used to store, transmit, and retrieve medical images and information.
   • DICOM facilitates the integrated management of images and patient data by fusing image data with patient information. A DICOM file normally includes the image data as well as a header that holds patient data, scan type, and other information.
   • A radiologist performs an MRI on a patient. The scan is saved as a DICOM file, which includes the patient’s information as well as the scan’s specifics. This file can be sent to other healthcare providers, who can view both the image and the accompanying patient information using a DICOM-compliant system.DICOM combines image data with patient information, allowing for integrated image and patient data management. A DICOM file typically includes a header (which stores information about the patient, type of scan, and so on) as well as the image data itself.

Ensuring Secure and Efficient Data Transfer

This section focuses on the communication protocols that are instrumental in the secure and efficient exchange of data in healthcare IT systems. Let’s break down the key protocols – RESTful APIs, SOAP, and Secure FTP – in more detail to understand their roles and technical aspects.

1. RESTful APIs
   • RESTful APIs are a popular choice in healthcare data exchange, particularly with the advent of FHIR. They use standard HTTP methods and are known for their simplicity and statelessness.
   • In a clinical application, to retrieve a patient’s medical record, the app might make a GET request to the FHIR server using a RESTful API. The server responds with the requested data in a structured JSON format that the application can then process and display.
2. SOAP
   • SOAP is a protocol used for exchanging structured information in web services. It is known for its high security and extensibility, making it suitable for complex enterprise-level healthcare applications.
   • A SOAP message may be used in a hospital information system to transmit sensitive patient data to a billing system. This message would be encrypted and could contain detailed patient billing information in a structured XML format.
3. Secure FTP (File Transfer Protocol)
   • Secure FTP is used for transferring large files or batches of data securely over the internet. It is essential for scenarios like transferring large medical imaging files or extensive patient records.
   • A healthcare provider needs to send a large number of patient records to a central health information exchange (HIE). Secure FTP can be used to encrypt and safely transmit these files.

The landscape of healthcare IT, particularly in the context of data transfer, is complex and ever-evolving. As professionals in this field, it is our responsibility to stay abreast of these changes, ensuring our systems are not only compliant with current standards but also prepared for future advancements.

The journey towards streamlined and secure data exchange is ongoing, and with the right expertise, your organization can navigate this path successfully.