Adopting Robust Solutions to Achieve Compliance With Interoperability Requirements

Scott Galbari, chief operating officer, Lyniate, shares challenges payers and providers have faced while trying to meet interoperability requirements and offers advice for organizations hoping to adopt new technologies to ease the process.

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Welcome back to PopHealth Perspectives, a conversation with the Population Health Learning Network where we combine expert commentary and exclusive insight into key issues in population health management and more.

In this episode, Scott Galbari offers advice for payers and providers to successfully comply with interoperability requirements.

I'm Scott Galbari. I'm the chief operating officer at Lyniate. I have the responsibility for leading our product management, product development, security, customer support, and professional services teams here at Lyniate.

From your perspective, how are payers and providers doing with compliance under the interoperability rule?

Yeah, it's a good question. I definitely anticipated more traction with these rulings being adopted than we've seen. The primary reason we believe it's been a little bit slower than anticipated is the pandemic.

Over the last couple years, our health system has been completely burdened with the pandemic. I want to start by saying thanks to all the health care workers who have been working constantly to take care of patients throughout the pandemic. As a result of that, though, we've definitely seen that the ability for organizations to focus on implementing these interoperability rules has been more challenging. They've been focused on what they need to do to facilitate alternative treatment or care pathways that are now needing support, whether it's telehealth or new locations, like popup COVID-19 lab locations. There's been all of this work to try to make those new workflows be successful during the pandemic.

On top of that, everyone's been trying to figure out how to work remotely. Organizations have been really adaptable. I see people have come up with creative ways to work remotely, but it's taken them some time to try to work that out. As they've been working through all these challenges, what we've seen is that customers know they want and need to focus on interoperability, but they've been unable to prioritize it.

Even with that, we’re definitely seeing a lot of traction with our customers around FHIR—looking at how to enable FHIR-based workflows in order to get consumers the data they need to be successful navigating their health care in the ecosystem.

What would you say are some of the biggest challenges organizations face with compliance?

The biggest challenge that we've seen is resourcing. I think everyone, regardless of the industry sector, knows the labor market has been completely disrupted with the pandemic. And health care is no exception.

What we're seeing is that organizations are really struggling to have the required knowledge around interoperability maintained in their organization. Too often, they have one individual or maybe a couple individuals that were their experts, and that individual may leave their company or be out due to illness.

Organizations are struggling with having the appropriate resources to do the work. They have a huge volume of work with the increase in care requirements that is coming in, but then you have all these demands from a regulatory perspective. So we see that customers have really struggled with being able to maintain the staffing needed to execute on all these priorities.

Thank you, Scott. What should payers and providers look for in a partner organization?

There are a lot of different things that I would highlight.

When you're looking for a partner, you're going to want to make sure that partner has significant experience in the area you're working on. In the case of interoperability, you're going to want someone that has experience with all aspects of interoperability and has worked with different stakeholders across the health care ecosystem, from payers and providers to digital health companies and public health organizations. You want to have a diversity of experience in dealing with different customers in all of the workflows that you'll encounter.

On top of that, you’ll want to find partners that can not only provide robust software platforms but can help you with some of those staffing issues I highlighted earlier, around having the resources you need. Whether the partner can provide fully managed services to help take on some of your integration needs, or they can leverage their knowledge and capabilities to take on your infrastructure challenges, that can help organizations focus on the things that are most important to them—the things that help them differentiate the services they're providing for their customers.

Another thing is this ability to find partners that understand and have been in health care interoperability for a long period of time, that have worked through all of the nuances of HL7 transactional messaging, but also have the capabilities to support API-style integrations. When we talk about interoperability rulings and requirements around FHIR-based communications, having a vendor that can support both that and the traditional messaging that exists between all of the information systems in health care organizations is really important.

I highlighted a slew of different things organizations should look for from a partner organization. Each one is important because of the complexity of the issue, as well as the needs that customers are going to have. There are needs they have today, but there are also going to be needs they have in the future, and you want to make sure your partner can support you on that.

Regulations will continue to change. There will be increased interoperability requirements that'll continue to come. At the same time, there's going to be a lot more data coming into the ecosystem, whether it's consumer devices, new medical devices, or new information systems. Everything is generating more and more data that's going into the health care digital record.

Thank you, Scott. And while we're on the subject of the future, after organizations meet minimum requirements, where should they go from there?

Once customers are able to meet the compliance requirements, we would encourage customers to think about how they can start to differentiate their offerings. Rather than just meeting a compliance requirement, how can you use the capabilities you just implemented to help provide a much better consumer experience to the end patient?

How do you now enable more applications that give the decision making and power to patients, to really own their journey through the health care ecosystem? Once you have it in place, you can say, “Hey, we met these regulatory requirements. Now, how can we actually implement consumer-facing applications that can leverage the data we’ve been able to expose through our digital front door?”

Is there anything else you would like to add today?

Interoperability is definitely a CMS requirement. It's clearly foundational to digital transformation. And it's really important for organizations to find robust partners that can help them navigate the challenges and complexity around all of these requirements and needs.

As I highlighted earlier, what's needed today is a subset of what's going to be needed in the future. We would anticipate that although it's complicated now for customers, there's a lot of work to be done.

We do believe that there are great options out there in the marketplace: great partners you can work with to get technology solutions in place; platforms that help you solve the variety of communication needs that you have; and also services that can help you augment your team, whether it's through staff augmentation or by asking a partner to take on the key integration activities that you need to accomplish.

It requires some investigating and understanding the capabilities of a partner, but I do think that although interoperability is complicated and there are lots of challenges around it, there are certainly really good options out there for organizations to leverage a partner to help them on that journey.

Thanks for tuning in to another episode of PopHealth Perspectives. For similar content or to join our mailing list, visit populationhealthnet.com.

This transcript has been edited for clarity.