I have posted a number of notes about HIT interoperability over the years (see: Judith Faulkner, EMR Interoperability, and Washington IT Politics; More on Epic's (Non)-Interoperability and the Recent NYT Puff Piece). Simply put, the term can be defined as the ability of the various, often heterogenous, hospital information technology systems such as EHRs to exchange patient clinical information. This functionality is very important to enable patients to seek care in multiple health facilities across the country.
Two of the most significant barriers to HIT interoperability are that some EHR vendors are not enthusiastic about data exchange with the EHRs of their competitors. They may, however, offer easy interoperability among their client hospitals as a sales feature. Secondly, health system executive officers often view the clinical data generated in their facilities as proprietary and they overtly, or covertly, relish barriers, sometimes created by their own vendors, to data interoperability. Here's a quote from one of my previous notes about CEO attitudes on this topic (see: Why Many Clinicians Dislike Their EMRs):
Clinicians [favor HIEs] because they need to learn about the previous histories of their patients in other facilities. CEOs usually support them only under intense pressure. HIEs promote patient mobility to other health systems and this runs contrary to the business model of most health system CEOs. They want to hang on to their customer/patients and consider clinical data proprietary.
A recent article addressed HIT interoperability saying that it will occur when the price of isolation by hospitals and health systems becomes too high (see: HIT interoperability will happen when the cost of isolation becomes too high):
In 2004, Dr. David Brailer, the first National Coordinator for Health IT, outlined the vision for implementing the federal mandate that “every American have an electronic record of the healthcare by 2014 and link all the records into one giant medical internet called the National Health Information Network.” Ten years elapsed and now we’ve allocated another ten years. Can we risk another decade to achieve what is commonplace across all industries – the flow of data?....Another ten years of cajoling diverse entities to embrace and use standards will not change the foundation of healthcare.... Healthcare, representing nearly a fifth of the U.S. economy will only change when the cost to any organization in the industry of being a data island exceeds the cost of being “connected.”....The winners, above all else, consumers; they will enjoy best care, best outcomes, easy access and affordable care. Beyond consumers, the organizations that innovate and find new ways to integrate data into their product, service or application. The connected organization will thrive; the data island will struggle for relevance.This industry transformation cannot be mandated or ordered into existence.
So here in a nutshell is the answer about when hospital executives will seek HIT interoperability -- when the value of it exceeds the value of non-interoperability. Federal incentives/payments for HIT interoperability will only result in half-hearted compliance.