The English language gets a bad rap for being a difficult language to learn–and understandably so. It’s rife with contradictions. A single misplaced comma can change the entire meaning of a sentence. And words that are spelled similarly aren’t always pronounced the same way.
Even trickier, though, is the language of healthcare–more specifically, healthcare IT. It’s nearly impossible to avoid the alphabet soup of TLAs (Three Letter Acronyms), and terms are often so overused (or incorrectly used!) that their correct definitions are no longer known.
Case in point: interoperability and intraoperability. While these two words may sound and look similar, their meanings couldn’t be more different. That one letter difference creates a world of distance between the two definitions. Despite this nuance, both are often used interchangeably, which has led to an industry-wide confusion about what is what, and which is more important.
The truth is, both are equally important, but in different contexts.
What is the difference?
We know that at the most basic level, inter- is a prefix used to signify something between or among groups, and intra- is a prefix used to form words that mean on the inside, or within a group or groups. So what does that mean for healthcare?
Interoperability has generated quite a bit of industry buzz recently–even being deemed one of the top health IT trends to watch in 2016.
The Healthcare Information and Management Systems Society (HIMSS) defines interoperability as the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Interoperability facilitates the exchange of data between clinicians, labs, hospitals, pharmacies, health plans, and local/state/Federal government regardless of location, size, software platform or vendor. All applications should have the capability to connect, send and receive information spanning organizations and applications.
This concept is increasingly vital as health systems and health plans take on mutual financial risk in the various incarnations of Accountable Care Organizations. And most of these health systems and health plans are using different EHR, claims, and financials systems. By creating an environment where information can not only be shared, but then compiled, analyzed and made actionable, organizations will be able to improve the delivery of healthcare by making the right data available at the right time to the right patients.
Yet all too often, when healthcare IT companies make grandiose claims about being interoperable, reality reveals the opposite – what they really are is intraoperable. And there’s a world of difference.
Intraoperability, definitely the lesser known of the two terms, describes the exchange of data between systems that are fundamentally the same, and generally developed by the same vendor. Unlike interoperability, intraoperability strictly focuses on operations within certain parameters, so there’s little need for custom extensions. And unfortunately, it is a truism among Arcadia teams and clients, that “if you’ve seen one instance of an EHR system, you’ve seen one instance of an EHR system.” Many EHR vendors have used their flexibility and customizability as a core benefit, but this often has the unintended consequence of poor intraoperability. True EHRs in the cloud, like athenahealth, can better enable intraoperability because of their ability to avoid custom extensions.
A health system or provider group may decide to create or implement a single EHR across all of its settings, enabling the quick and easy access of information across the care continuum—to be intraoperable. But the data would only be accessible by providers on that particular system without a parallel focus on interoperability. Should a patient see a provider in a surrounding, unaffiliated network, this information would not be easily accessible and may affect the quality or appropriateness of care provided.
It’s worth noting that a crucial component of interoperability is the ability of health information systems to work together within and across organizational boundaries. So intraoperability could be viewed as a subset of interoperability.
The ability to meaningfully share, analyze and use patient data is paramount to the success of the healthcare industry—which is why both of these terms are so important. Arcadia allows healthcare providers to be both inter- and intra-operable, and beyond—connecting more than 30 different EHRs and combining that with claims data to provide a full and complete picture of patient care. Without this data, it is nearly impossible for providers to make an informed decision about a single patient or a patient population. Technologies that can integrate and analyze data from multiple systems will be increasingly vital for healthcare organizations to improve care outcomes and drive financial performance.