Healthcare interoperability refers to the ability of different information technology systems and software applications to communicate, exchange data accurately, effectively and consistently, and use the information that has been exchanged. Lack of interoperability leads to redundant tests, medical errors due to missing information, and higher costs. There are several interoperability challenges in healthcare such as lack of incentives to share data, differing formats and standards for representing data, privacy and security concerns, technological barriers, and financial and operational barriers. A capstone project can help address these challenges and advance interoperability in a meaningful way.
One way a capstone project could address interoperability challenges is by developing open source tools and applications to facilitate data sharing across different health IT systems. The project could focus on creating standardized formats and templates to structure and represent different types of clinical data such as medical records, lab results, billing information, etc. International standards like HL7 and FHIR could be used to develop software components like API’s, data mapping tools, terminology servers etc. that allow disparate systems to effectively communicate and interpret exchanged data. These open source tools could then be made available to hospitals, clinics, labs and other providers to seamlessly integrate into their existing workflows and infrastructure.
Another approach could be developing a centralized registry or directory of healthcare providers, systems and services. This will enable easy discovery, lookup and connection between otherwise isolated data “islands”. The registry could maintain metadata about each participant detailing capabilities, supported standards, data available etc. Secure authorization mechanisms can help address privacy and consent management concerns. Subscription and notification services can automatically trigger relevant data exchanges between participants based on treatment context. Incentives for participation and ongoing governance models would need to be considered to encourage adoption.
A capstone project could also evaluate and demonstrate tangible clinical and financial benefits of interoperability to help address stakeholders’ resistance to change. For example, detailed cost-savings analysis could be conducted on reducing duplicative testing, medical errors caused due to lack of complete patient data. Studies estimating lives saved or improved health outcomes from optimized treatment decisions based on comprehensive longitudinal records spanning multiple providers could help garner support. Pilot implementations with willing trial sites allow demonstrating proof of concept and quantifying ROI to convince skeptics. Standardized framework for calculating return on investment from interoperability initiatives will build consensus on value.
Developing user-friendly consent and control frameworks for patients and other end users is another area a capstone could focus on. Enabling easy ways for individuals to share their data for care purposes while retaining fine-grained control over which providers/systems can access what information would help address privacy barriers. Standard electronic consent forms, consolidated personal health records, permission management dashboards are some solutions that uphold individual autonomy and build trust. Audit logs and self-sovereign identity mechanisms can provide transparency into data usage.
Addressing technology barriers is also critical for interoperability. The capstone project could prototype reference architectures and best practices for integrating new systems, migrating legacy infrastructure, storing/retrieving data across diverse databases and networks etc. Standard APIs and connectivity layers developed as part of the open source toolkit mentioned earlier help shield disparate applications from underlying complexity. Packaging validated integration patterns as cloud-hosted services relieves resource-constrained providers of such responsibilities.
Sustained stakeholder engagement is important for success and sustainability of any interoperability initiative post capstone project. Operationalizing governance models for change management, certification of new implementations, tracking of metrics and ongoing evolution of standards are important remaining tasks. Knowledge transfer workshops, formation of a consortium and seed funding are some ways the capstone can support continued progress towards its goals of improving health data sharing and overcoming barriers to electronic interoperability in healthcare.
There are many ways a capstone project can comprehensively address the technical, financial, policy and social challenges holding back seamless exchange of health information across organizational boundaries. By developing reusable open source tools, demonstrating ROI through pilots, fostering multi-stakeholder collaboration and outlining future roadmaps, capstone projects can act as catalysts to accelerate the progress of the interoperability agenda and advance the quality, efficiency and coordination of patient care on a wider scale. With a rigorous, multi-dimensional approach leveraging diverse solutions, capstones have real potential for driving meaningful impact.