Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Oct 27, 2022
Date Accepted: Jan 19, 2023
Multi-Stakeholder Perspectives on Challenges and Opportunities for Interoperability
ABSTRACT
Background:
Interoperability - the exchange and integration of data across the healthcare system - remains a challenge despite ongoing policy efforts aimed at promoting interoperability.
Objective:
The aim of this study was to identify the current challenges and opportunities to advance interoperability across stakeholders.
Methods:
Primary data collected through qualitative, semi-structured interviews from stakeholders (n=24) in Ohio were conducted from July to October 2021. Interviewees were sampled using a stratified purposive sample of key informants from four representative groups: 1) acute-care and children’s hospital leaders, 2) primary care providers, 3) behavioral health providers, and 4) regional health information exchange networks. Interviews focused on key informant perspectives about EHR implementation generally, the alignment of public policy with organizational strategy, interoperability implementation challenges, and opportunities for health information technology. Interviews were transcribed verbatim followed by rigorous qualitative analysis using directed content analysis.
Results:
Findings illuminate themes related to challenges and opportunities for interoperability that align to technological (i.e., implementation challenges, mismatches in interoperability capabilities across stakeholders, and opportunities to leverage new technology and integrate social determinants of health data), organizational (i.e., facilitators of interoperability, and strategic alignment of participation in value-based payment programs with interoperability), and environmental (i.e., policy) domains.
Conclusions:
Interoperability, while technically feasible for most providers, remains challenging for technological, organizational, and environmental reasons. Our findings suggest that incorporation of end-user considerations into health information technology development, implementation, and policy and standards deployment may support interoperability advancement.
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