The new consumer-driven health information ecosystem is transforming the way health systems deliver care. As always, interoperability – be it among care teams or across disparate settings – is a key challenge.

While major strides are being taken to improve the way medical data and electronic health records can be transferred, analyzed and shared, major hurdles to full interoperability remain, and will be a key development point in healthcare IT this year.

"I see the barriers being the way standards are defined and implemented," James Lloyd, co-founder and CTO of Redox, told Healthcare IT News.

"Currently, standards are intentionally customizable and extensible, and this flexibility leaves a lot of decision making to the implementers, namely EHR vendors, software vendors and health systems."

Lloyd explained that from a business standpoint, the biggest change and pressure point for interoperability in 2020 will be the final rules expected soon from the Department of Health and Human Services on the information blocking prohibition in the 21st Century Cures Act.

"Although no one is sure when this will officially be out, and companies are still trying to plan around the uncertainty," he said.

"When the rule is passed, we'll see how it will impact the decision making of health systems, as well as how the government will enforce the rule. It needs teeth for health systems to change their behavior and buy in, but many questions remain pertaining to who will solve this."

Niko Skievaski, Redox's co-founder and president, said in terms of two health systems sharing data, the core problem is the business model and thus adoption.

"In a fee-for-service world, interoperability is difficult to execute. The economic incentives to share data does not align with the need for interoperability," he said.

"In order for this to work, the industry must continue to shift to a value-based care model where the business incentives do align around interoperability as various care providers need to share data to better collaborate and reduce costs."

Lloyd also noted an area that will drive a new type of interoperability are more diagnostic-type services moving into the hands of individuals: for example, mail order blood tests or colon cancer tests.

"It is moving services away from a centralized location and centralized technology to these condition-specific technologies that are not immediately connected to the four walls of a health system," he noted. "This drives the importance of interoperability."

Skievaski said as developers begin producing apps, more data will be freed from silos and flow to patients, and these apps will come to life with the emergence of a mandate for patient-directed access to data and data exchange.

"We need a killer app to drive patient and health system demand for interoperability," he said. "This kind of app should bring value to consumers that it becomes indispensable."

George Gray, chief technology officer and vice president of research and development at Ivenix, said in 2020, bidirectional integration will continue to gain adoption – but not without some bumps and bruises.

"We'll also continue to see AI advance in healthcare around the diagnosis of disease and other medical conditions that lend themselves well to pattern matching," he said. "I expect to start seeing more AI capabilities built into patient monitoring solutions both inside and outside the hospital in 2020."

He also noted that while vendors and healthcare systems are all in agreement that adopting interoperability is important, until vendors offer or provide the level of interfaces needed to become truly interoperable, progress of interoperability will stall.

"This means vendors must continue to innovate and make their products better," Gray said. "In the future, integration and interoperability with the devices that they are connected to will be a growing pain point throughout the healthcare industry."