New indices to track interoperability among US hospitals.

Area of Science:

• Health Informatics
• Health Services Research
• Health Information Technology

Background:

• Measuring hospital interoperability is crucial for assessing health IT adoption and exchange capabilities.
• Existing methods may not fully capture the nuances of interoperability across diverse healthcare settings.
• Standardized indices are needed to track progress and identify areas for improvement.

Purpose of the Study:

• To develop and validate indices for measuring US hospital interoperability.
• To assess the current state and track progress of hospital interoperability from 2021 to 2023.
• To identify factors associated with higher or lower interoperability performance.

Main Methods:

• A Technical Expert Panel (TEP) guided the selection of items from the American Hospital Association Health IT Supplement survey.
• Interoperability concepts were aggregated into indices: Core, Pathfinder, and Friction.
• Indices were psychometrically analyzed and refined, with annual calculations from 2021-2023.

Main Results:

• The Core Index (foundational capabilities) scored 61 in 2023, Pathfinder (advanced capabilities) scored 57 in 2022, and Friction (barriers) scored 30 in 2023.
• Larger hospitals, non-critical access facilities, metropolitan hospitals, and those using leading EHRs showed significantly higher scores.
• Modest improvements in index values were observed over the study period.

Conclusions:

• Hospitals demonstrated the strongest performance on the Core Index, indicating foundational interoperability is more widespread.
• Anticipated continued improvement in all indices is expected due to recent policy and programmatic initiatives.
• Continuous monitoring of these indices can evaluate policy effectiveness and reveal persistent interoperability disparities among hospitals.