Socioeconomic conditions are widely considered the top drivers of inequities within healthcare.
In the health IT industry, it may seem difficult to ascertain how best to help promote greater health equity, but, the answer for many of us lies in enhancing the interoperability of health information.
First, let’s be honest: Addressing America’s struggles to achieve broader health equity is a complex, decades-long undertaking that will require grappling with numerous longstanding economic, social, and political challenges. Interoperability is far from a silver bullet to solving these historic societal problems. Instead, interoperability acts as an enabler, one avenue out of perhaps thousands, towards reducing gaps in health equity.
Disclaimers aside, interoperability, which is the ability of systems to securely connect and exchange information, does offer the potential to improve the quality of care by providing more comprehensive, accurate health information to doctors and other providers, to patients and their caregivers, as well as to healthcare payers, and others with a valid need when they are making both routine and critical care decisions.
Deeper insights into patients’ needs
Many of today’s limitations on healthcare interoperability stem from the nature of health IT systems, which are proprietary and may differ between providers, according to an article in the journal BMC Medical Informatics and Decision Making. Patient health information is often fragmented across multiple healthcare facilities and other data holders, making it inaccessible to providers outside the originating institution. As a result, healthcare professionals may lack critical medical information unless the patient is conscious, willing and able to communicate it, hindering fully informed decision-making.
To make well-informed decisions about appropriate prescriptions, procedures and other interventions, healthcare professionals require access to patient information that is typically spread across multiple institutions. When a lack of such information leads to an error, resolving the issue becomes significantly more challenging — if not infeasible. Hence the need for better interoperability.
A lack of interoperability results in “redundant, disorganized, disjointed and inaccessible medical information, that may affect the quality of care provided to patients and a waste of financial resources,” according to the article. In contrast, improved interoperability leads to better and safer care for patients while enhancing public health and health service management.
As a practicing physician, I see the value of interoperability every day. One common scenario involves maternal health. Pregnant women often receive their prenatal care in a different health system than where their deliveries occur; and after birth, their babies may receive pediatric care in yet another system. Additionally, sometimes new mothers move to different regions of the country during the perinatal period.
Interoperability allows us to access important data about the mother and child across different settings and institutions to ensure that clinicians have all the data necessary for fully informed decision-making at their fingertips.
A recent federal program known as TEFCA (The Trusted Exchange Framework and Common Agreement) aims to establish the technical standards needed to support and scale interoperability across key healthcare stakeholders for multiple exchange purposes.
Interoperability’s paradox: When too much is a bad thing
One often-overlooked, paradoxical aspect of interoperability is when it leads to sharing specific patient information with providers that patients would prefer not to share with. When this occurs, health IT systems are effectively forcing patients to choose between care and privacy, according to the Shift Collaborative, an industry group that has done extensive work focused on ensuring equitable interoperability.
Shift highlights several thought-provoking use cases that illustrate why a patient may seek to freely share portions of their health information with some providers or institutions but not others, such as social drivers of health (SDoH) data. For example, consider a situation in which a woman with a known history of intimate partner violence or other social health concerns wants to keep that information confidential. She’s worried about such information being visible in the patient portal, shared between healthcare systems, or accessed by third-party apps that may not comply with HIPAA privacy standards.
This is important because details about a patient’s SDoH, such as education, housing, income, food insecurity, or experiences with violence, are essential for providing comprehensive care, yet they may be highly sensitive. When such information is shared through systems lacking robust privacy protections, patients may face serious risks — including stigma, discrimination, or threats to their personal safety.
Without fine-tuned privacy controls, SDoH and other highly sensitive data can be mishandled or exposed, particularly when shared with community organizations or mobile apps outside the traditional healthcare environment. This scenario highlights the pressing need for consent-aware systems that help to safeguard both patient autonomy and coordinated care. (Another group doing valuable work to support the appropriate exchange of SDoH data is the Gravity Project, which is developing technical standards for sharing this often-complex information.)
Conclusion
Improving the interoperability of health information holds meaningful promise in advancing health equity by enabling healthcare providers and other stakeholders to access a more complete picture of a patient’s medical history and other relevant information across care settings. It empowers patients and caregivers, enhances clinical decision-making, reduces redundancies, and supports safer, more coordinated care — particularly in complex scenarios such as maternal health, behavioral health, and the increasingly common situation of multiple chronic conditions. As we expand data sharing, however, we must also recognize the risks posed by exposing sensitive patient information without proper safeguards. Ensuring that interoperability efforts are built on secure, consent-aware, privacy-respecting systems is essential to protecting patient autonomy while promoting equitable access to care. Ultimately, thoughtful, secure interoperability can be a powerful catalyst for closing equity gaps in healthcare.
Photo: LeoWolfert, Getty Images
Dr. Steven Lane is the Chief Medical Officer at Health Gorilla and a nationally recognized leader in health data interoperability. As a practicing primary care physician, he brings deep clinical insight to his work advancing nationwide health information exchange. From 2020 to 2024, Dr. Lane served as Chair of the Carequality Steering Committee, helping guide one of the nation’s most influential interoperability frameworks. He has also served on federal advisory bodies such as the ONC’s Health Information Technology Advisory Committee (HITAC). At Health Gorilla, he bridges the gap between policy, technology, and frontline care to ensure that data exchange delivers real-world clinical impact.
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