How to find the right interoperability partner

© teguhjatipras - stock.adobe.com

The health care industry continues to make slow but steady progress toward the long-sought goal of interoperability. One key step was the Trusted Exchange Framework and Common Agreement, known as TEFCA, which went operational in late 2023. TEFCA supports health data sharing by creating an interconnected nationwide “network of networks.”

Bob Watson © Health Gorilla

Health care organizations, such as providers, payers and electronic health records system developers, connect to these networks — called Qualified Health Information Networks (QHINs) — to exchange critical health information. To become a QHIN, a network must pass rigorous technology and security testing and agree to the same rules of engagement for itself and its members.

Strides toward interoperability

Before TEFCA, more U.S. hospitals were already making strides in interoperability. For example, 70% of nonfederal acute care hospitals engaged in all four domains of interoperable exchange (send, find, receive and integrate) in 2023, up from 46% in 2018, according to the most recent statistics from the U.S. assistant secretary for technology policy.

Despite this top-line progress, a deeper look reveals significant gaps among the types of hospitals that are “routinely interoperable,” with 53% of large hospitals achieving the distinction compared with just 38% of small hospitals. Similar gaps were noted in system-affiliated hospitals (53% routinely interoperable) compared with independent (22%), as well as urban (47%) versus rural (36%).

To maintain the momentum of interoperability, more health care organizations will engage with QHINs to facilitate data exchange with other entities. However, given the novelty of TEFCA and QHINs, many organizations may be unsure of what qualities to look for in interoperability partners. As a result, key considerations around selecting the right network partner include what the partner will do with the data, the interoperability partner’s experience and expertise, the quality and usability of the data it will deliver, and the partner’s financial strength.

Advantages of interoperability

Improved interoperability and seamless health data exchange offer benefits to health care providers and patients. With the national rollout of TEFCA, health care entities now have an infrastructure to support safe, standardized data sharing. This connectivity helps bridge information gaps that have historically led to fragmented care.

For health care providers, having access to a complete picture of a patient’s medical history allows for more accurate diagnoses and timely, evidence-based treatment decisions. When providers can review prior labs, prescriptions, procedures and specialist consultations in real time, they can avoid duplicative testing and reduce the risk of medical errors. This is especially important in value-based care models, where providers are rewarded for outcomes, not volume.

Patients also benefit significantly from greater interoperability. With the ability to easily request and share their health information across providers and settings, patients are empowered to take a more active role in their care. For example, streamlined individual access services can simplify life insurance applications or enable faster care transitions after moving or switching providers.

Moreover, effective data exchange contributes to operational efficiencies for payers and health care administrators. By reducing the need for manual chart retrievals and improving data accuracy for claims and care coordination, interoperability supports cost savings and better resource allocation.

What to seek in a partner

As health care organizations evaluate potential QHIN partners, several criteria should guide their decision-making.

Data usage practices: Organizations should understand how their data will be handled before entering a partnership. Some vendors may aggregate and resell deidentified patient data, which may not align with an organization’s ethical standards or patient trust objectives. Clarity around data use policies is critical.

Track record and expertise: A potential partner’s leadership team should demonstrate deep knowledge of health care and information technology. Decision-makers should look for organizations with a proven ability to navigate complex regulatory landscapes, support evolving compliance needs, and maintain technical excellence across large-scale implementations.

Data quality and integration: Clean, normalized and usable data should be a nonnegotiable demand. Providers must ask whether the platform delivers deduplicated, structured data that integrates with electronic health records and other internal systems. This usability determines whether interoperability efforts translate into better patient care.

Financial health: Organizations should ensure prospective partners are financially stable and poised for long-term growth. For example, firms with strong cash reserves and demonstrated year-over-year revenue growth are more likely to provide ongoing support, innovate continuously, and weather industry downturns.

Comprehensive capabilities and vision: A good interoperability partner should offer more than just data exchange. Organizations should evaluate the partner’s ability to support future needs like public health reporting, patient access tools and analytics-driven decision-making. It’s also wise to request the company’s product roadmap. Partners that invest in new technologies and support services are better positioned to grow alongside their clients.

Conclusion

Interoperability is no longer a nice-to-have; it’s a necessity. With TEFCA providing a national framework and QHINs emerging as key players, the industry is poised for transformative progress. Providers and patients stand to gain from better access to data, improved care coordination and a more efficient health care system.

However, the benefits of interoperability depend on choosing the right partner. Health care organizations should look beyond surface-level offerings to assess a QHIN’s data integrity, leadership expertise, financial footing and long-term strategy. A well-aligned partnership can ensure compliance, enable innovation and deliver measurable improvements in patient outcomes and operational performance.

Bob Watson is executive chairperson of Health Gorilla.