There has been quite a bit written about healthcare delivery systems and integration versus interoperability. “Interoperability” and “integration” have become general terms, which many people use synonymously to talk about data connectivity.

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The words, in fact, are not the same, and the difference matters. While a lot has been written about interoperability and healthcare, the terms apply just as importantly to benefits administration, where people toss around the words, “integrated” or “unified” without really being clear on what they mean.  So, let’s start by figuring out the difference between these two terms.

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Bringing Clarity to the Conversation
The Integration and Interoperability Steering Committee of the Healthcare Information and Management System Society (HIMSS) offers clear definitions: “Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.”

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So, with interoperability, systems work together—even if they weren’t designed specifically to work together—because standard communication protocol techniques are applied. With interoperability, all patient information can be seen, exchanged and used across different platforms.

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Now take a look at the definition of integration: “…arrangement of an organization’s information systems in way that allows them to communicate efficiently and effectively and brings together related parts into a single system.”

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When non-interoperable systems are developed, it takes more time and effort to get them working together. Special custom coding is needed to connect (or integrate) them. Two (or more) systems that weren't designed to be interoperable require integration.

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Examples
Telephones offer a clear example of interoperability. It doesn’t matter where you are, what kind of phone you have or whether the phone connects to a landline or wireless network, any phone can call any other phone.

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Most people agree that interoperability beats integration when it comes to healthcare delivery—especially the automation aspects of healthcare. Doctors, patients, and everyone who works for or with either group benefit from systems that apply standards and achieve interoperability.

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In fact, according to Brightree CEO Dave Cormack, while integration and interoperability are both important, interoperability is the new frontier in health care.

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Interoperability Is the Future.
I agree and would like to suggest that the future of benefits administration is interoperability. Right now, an opportunity exists to connect systems across boundaries (making them interoperable) to improve efficiency and accuracy of benefits administration for both consumers and providers.

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For example, why don’t we make verifying patient eligibility under a certain benefit at the point of service—in the doctor’s office—as easy as making a phone call or looking it up on your smartphone or providing simple lookup from a single-source while in line at the pharmacy?  

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As interoperability evolves in benefits administration, we need to make eligibility, enrollment, costs, copays, claims, in- and out-of-network benefits, privacy and more, a seamless process for patients and providers. By breaking down silos of information through interoperability, benefits administration becomes simplified and transparent.

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As benefits administration and HR systems evolve, it is crucial that they are interoperable with the same standards and specifications with other platforms, so they do not need to be integrated, adding more work and complexity. Users are starting to expect this kind of communication, and soon they will demand it. Let’s work together and get it right for everyone’s sake.

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If you’d like to talk about how Hanna Global Solutions can help you provide the best benefits to your employees, visit our website at http://www.hannaglobal.com/ or email me at Michael.Fleck@hannaglobal.com.

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