Advancing Hospital Interoperability: Introducing a New Set of Measurement Indices

Interoperability Report Card: New Indices Track Healthcare Data Exchange

A new set of indices – the Core Index, Pathfinder Index, and Friction Index – are offering a detailed look at the state of healthcare interoperability across the nation. Developed through survey data,these measures aim to provide policymakers and stakeholders with a consistent way to monitor progress and identify areas needing improvement in the seamless exchange of health data.

The Core Index (2023) focuses on foundational interoperability,while the Pathfinder index (2022) assesses more advanced capabilities. The Friction Index (2023) quantifies the challenges hospitals face in actually exchanging data.

Here’s a rapid breakdown of what each index examines:

Core Index (2023) | Pathfinder index (2022) | Friction Index (2023)
—|—|—
Clinical Interoperable Exchange | Clinician / Health System APIs | Barriers to Exchange
Clinical Information Availability and Use | Patient Engagement | Numerous Methods of Exchange
Breadth of Exchange Partners | Social Determinants of health | Experience of Information Blocking
| Public Health Data Submitted by EHR / HIE |

each component within the indices is scored equally and combined to produce a final score on a scale of 0-100. The Pathfinder Index will be recalculated biennially (next in 2024), while the Core and Friction Indices will be updated on odd-numbered years (next in 2025).

Key Findings:

Initial results indicate hospitals with strong foundational interoperability capabilities – those scoring high on the Core Index – generally outperform those focused on advanced features measured by the Pathfinder Index. The Friction Index reveals moderate levels of difficulty for hospitals, notably concerning obstacles to data exchange and the need to utilize multiple methods for information sharing.

Why This Matters:

These indices aren’t just about assigning scores. They provide a crucial baseline for tracking interoperability over time.By monitoring individual component scores, policymakers can pinpoint specific issues and evaluate the effectiveness of targeted interventions.

The data also highlights disparities in performance. Hospitals that are smaller, designated as critical access, located outside of metropolitan areas, or utilize less prevalent Electronic Health Record (EHR) systems consistently score lower on both the Core and Pathfinder indices. Longitudinal tracking will reveal whether these gaps persist or narrow.

Ultimately, these indices offer a tool – similar to economic indicators – for policymakers to assess the national landscape of healthcare interoperability, refine policies, and transparently communicate progress towards a more connected healthcare system.

How might the AII framework be adapted to assess interoperability within a regional health details exchange (HIE)?

The Critical Need for Hospital Interoperability

Hospital interoperability – the seamless exchange of health information between systems – is no longer a ‘nice-to-have’ but a fundamental requirement for modern healthcare. As evidenced by the escalating challenges in conflict zones like Gaza (WHO report, May 22, 2025), where health systems are overwhelmed and resource allocation is critical, effective data sharing can literally be a matter of life and death. Beyond crisis situations,improved data exchange leads to better patient outcomes,reduced costs,and enhanced operational efficiency. However, measuring the success of interoperability initiatives has been a persistent challenge. Existing metrics often focus on technical aspects, neglecting the crucial clinical and operational impact.

Introducing the ARCHYDE Interoperability Index (AII)

To address this gap, we’re introducing the ARCHYDE Interoperability Index (AII), a new set of measurement indices designed to provide a holistic view of hospital interoperability. The AII moves beyond simply tracking the volume of data exchanged and focuses on the value derived from that exchange.It’s built around four core pillars:

Technical Interoperability: Assessing the foundational ability of systems to connect and exchange data.

Semantic Interoperability: Evaluating the consistency and meaning of data across different systems.

Clinical Interoperability: Measuring the impact of data exchange on clinical decision-making and patient care.

Operational Interoperability: Determining how data sharing streamlines workflows and improves hospital efficiency.

Deconstructing the ARCHYDE Interoperability Index (AII) – Key Metrics

Each pillar within the AII is assessed using a combination of quantitative and qualitative metrics. Here’s a detailed breakdown:

1. Technical interoperability (Weight: 25%)

API Usage Rate: Percentage of systems utilizing standardized APIs (FHIR, HL7) for data exchange.

Data Exchange Volume: Total amount of data exchanged electronically per month.

System Connectivity Rate: Percentage of critical hospital systems successfully connected for data sharing.

Security Compliance: Adherence to HIPAA and other relevant data security regulations.

2. Semantic Interoperability (Weight: 30%)

Standardized Terminology Adoption: Percentage of clinical data mapped to standardized terminologies (SNOMED CT, LOINC, ICD-10).

Data Quality Score: Accuracy, completeness, and consistency of exchanged data, measured through automated validation rules.

Vocabulary Alignment: Degree of alignment between different systems’ vocabularies and coding systems.

data Harmonization Rate: Percentage of data fields successfully harmonized across systems.

3. Clinical Interoperability (Weight: 30%)

Alert Fatigue Reduction: Decrease in clinically irrelevant alerts generated due to improved data context.

Duplicate Test Order Reduction: Percentage decrease in unnecessary repeat tests due to access to prior results.

Care Coordination Advancement: Measured through patient surveys and clinician feedback on the ease of coordinating care across different settings.

Medication Error Reduction: Decrease in medication errors attributable to improved access to patient medication history.

4. Operational Interoperability (Weight: 15%)

Administrative Task automation: Percentage of administrative tasks automated through data integration (e.g., insurance verification).

Reporting Efficiency: Time saved in generating reports due to readily available, integrated data.

Revenue Cycle Improvement: Reduction in claim denials and faster reimbursement cycles.

Bed Turnover Rate: Improvement in bed turnover rates due to streamlined patient flow information.

Benefits of Implementing the AII

adopting the ARCHYDE Interoperability index offers several key advantages:

data-Driven Decision Making: Provides a clear, quantifiable assessment of interoperability progress.

Targeted improvement Efforts: Identifies specific areas where investment and improvement are needed.

Demonstrable ROI: Allows hospitals to demonstrate the value of interoperability initiatives to stakeholders.

Benchmarking Capabilities: Enables comparison of interoperability performance against industry peers.

Enhanced Patient Safety: Ultimately contributes to improved patient care and safety through better data access and coordination.

Practical Tips for Implementing the AII

start Small: Begin by focusing on a specific clinical area or department.

Secure Executive Sponsorship: Gain buy-in from hospital leadership.

Invest in Data Governance: Establish clear policies and procedures for data quality and security.

Utilize Interoperability Platforms: Leverage platforms that support standardized apis and data exchange protocols.

Continuous Monitoring & Improvement: regularly track AII metrics and adjust strategies as needed.

Real-World Examples & Case studies

While widespread adoption of a comprehensive index like the AII is still emerging, several hospitals are demonstrating the power of focused interoperability initiatives. For example, Intermountain Healthcare has successfully implemented a system-wide data exchange platform