"Those keys are just starting to come to fruition," she says. "We've taken a strong strategic role in making this happen. We have 200 or more HIEs out there and interoperability isn't just about provider-to-provider data flow, but it is where we need to focus. As a vendor we need to align our service offering to connect two exchanges based on the needs of providers to make sure we are aligned with meaningful use and ACOs."

Introspective interoperability

While the overarching focus of the interoperability movement has been on sharing patient data externally between different providers, interoperability within a facility has also been a significant movement that is gaining steam. Specifically, interoperability between a patient's electronic medical record and the operation of medical devices has been an area of heightened interest at Wexner Medical Center at The Ohio State University.

Using an interoperability solution from Panama City, Fla.-based iSirona, Wexner is pulling device-oriented data sources into the EMR automatically as opposed to having the data entered manually by the clinical staff.

Kevin Jones, assistant director for business systems, says the system went live in 2011 and that currently all patient monitors and ventilators house-wide are connected and reporting data in real time. By connecting devices and the EMR, clinicians no longer have to spend time entering that data, saving labor while improving accuracy.

"To date the focus has been on high acuity areas such as the ICU and OR," Jones said. "We are now kicking ahead to anesthesia and eventually on to infusion pumps."

By deploying the calculations from the device, the organization can use the data for best practices and documentation, Jones said. Because the system signals when a patient is headed for problems, he said the staff could intervene before a negative episode can occur.

CIO Phyllis Teater says she is satisfied with Wexner's level of interoperability at this point because it has reached Stage 7 of the HIMSS Analytics EMR Adoption Model, which only 2 percent of organizations have reached to date.

The RTLS connection

Although used by hospitals mainly for asset tracking and temperature monitoring, real time locating systems have a link to interoperability through caregiver tracking and real-time coordination of care with workflow, says Jay Deady, CEO of San Diego-based Awarepoint.

While Deady sees progress occurring with interoperability across the healthcare spectrum, he contends that the real-time delivery of healthcare is where the true impact is and that it is still in the early stages of development.

Awarepoint's solution is focused on using RTLS technology with "a very sophisticated workflow feature" that enables 35 to 40 LEAN and Six Sigma milestones for electronic health records, compared with seven or eight for other modules, Deady said. The system captures caregiver interactions with workflow and coordination of medical equipment.