Evaluate one of the Interoperability levels

According to HIMSS, interoperability “describes the extent to which systems
and devices can exchange data, and interpret that shared data. For two
systems to be interoperable, they must be able to exchange data and
subsequently present that data such that it can be understood by a user.”
There are four levels of interoperability:
1. foundational
2. structural
3. semantic
4. organizational
Foundational interoperability: the ability of one I.T. system to send data to
another I.T. system. The receiving I.T. system does not necessarily need to
be able to interpret the exchanged data — it must simply be able to
acknowledge receipt of the data payload. This is the most basic tier of
Structural interoperability: “the uniform movement of healthcare data from one
system to another such that the clinical or operational purpose and meaning
of the data are preserved and unaltered,” HIMSS states.
In order to achieve structural interoperability, the recipient system should be
able to interpret information at the data field level. This is the intermediate
level of interoperability.
Semantic Interoperability: the ability of health I.T. systems to exchange and
interpret information — then actively use the information that has been
exchanged. Semantic interoperability is the highest level of
interoperability.“Semantic interoperability takes advantage of both the
structuring of the data exchange and the codification of the data, including
vocabulary so that the receiving information technology systems can interpret
the data,” stated HIMSS.
Achieving semantic interoperability allows providers to exchange patient
summary information with other caregivers and authorized parties using
different EHR systems to improve care quality, safety, and efficiency.
This level of interoperability allows healthcare organizations to seamlessly
share patient information to reduce duplicative testing, enable better-informed
clinical decision-making, and avoid adverse health events.
Effective health data exchange can also help to improve care coordination,
reduce hospital readmissions, and ultimately save hospitals money.
“New” Organizational (Level 4) – includes governance, policy, and
social. While semantic interoperability is the goal, most healthcare
organizations are still working to establish foundational and structural
Hospitals and health systems can utilize existing health data standards to
achieve lower levels of interoperability and set a solid foundation for future
improvements in health data exchange.
Evaluate one of the Interoperability levels listed above.
Include the following aspects in the discussion:
• Using your text and other course resources, assess one of the following
levels listed above and its importance in achieving full interoperability.
• Discuss technical and economic barriers hospitals face in achieving
your chosen level of interoperability.
• Explore the role the government plays in your chosen level.
• Share suggestions as a health care leader to support the development
of your chosen level.


Information blocking poses a threat to the benefits of EHRs and health I.T.
The Office of the National Coordinator for Health Information Technology
(ONC) describes information blocking as the intentional and unreasonable
blocking of health information among health I.T. systems. This practice does
not include the blocking of information for health data privacy reasons or
because of reasonable barriers. Federal organizations, including The Centers
for Medicare & Medicaid Services (CMS) and ONC, have increased pressure
on providers and health I.T. companies still engaging in information blocking.
In addition to federal policies, incentive programs also underscore the
importance of putting an end to information blocking. As part of the MeritBased Incentive Payment System (MIPS) under the Quality Payment Program
(QPP), providers must attest to the prevention of information blocking
reporting requirements. There are several actions ONC and other federal
agencies can take to address certain aspects of the information blocking
These actions include:
1. Proposing new certification requirements that strengthen surveillance of
certified health I.T. capabilities “in the field.”
2. Proposing new transparency obligations for certified health I.T.
developers that require disclosure of restrictions, limitations, and
additional types of costs associated with certified health I.T. capabilities.
3. Specifying a nationwide governance framework for health information
exchange that establishes clear principles about business, technical,
and organizational practices related to interoperability and information
4. Working with the Centers for Medicare & Medicaid Services to
coordinate health care payment incentives and leverage other market
drivers to reward interoperability and exchange and discourage
information blocking.
5. Helping federal and state law enforcement agencies identify and
effectively investigate information blocking in cases where such conduct
may violate existing federal or state laws.
6. Working in concert with the HHS Office for Civil Rights to improve
stakeholder understanding of the HIPAA Privacy and Security standards
related to information sharing.
Reflect on ways to prevent Information blocking.
Include the following aspects in the discussion:
• Choose one of the actions to address the information blocking problem
• Choose an aspect not already chosen by a peer
• Find two scholarly recent (less than three years) references about your
chosen action
• Summarize the action and explain how it can help with solving the issue
• Discuss the reasons why providers and vendors are still engaging in
information blocking and the impact on patient outcomes