Enhancing Healthcare Data Interoperability: Paving the Way for Patient-Centered Care

The Electronic Medical Record (EMR) system has become an essential tool in modern healthcare. However, due to inconsistent formats and a lack of interoperability, hospitals struggle to exchange medical data efficiently. As a result, patients must manually transfer their records when changing hospitals, leading to duplicate tests, unnecessary costs, and delays in treatment. These inefficiencies ultimately degrade the quality of care.

To overcome these challenges, healthcare data interoperability is gaining prominence. Seamless data exchange between institutions is key to patient-centered care. A recent Seoul National University Hospital (SNUH) study outlined strategies to strengthen interoperability in South Korea’s healthcare system.

(Note: This research was initially led by Professor Yoon Kim of Seoul National University College of Medicine. Following his candidacy for the National Assembly, Professor Changwook Jung of SNUH took over and finalized the study.)

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Why Is EMR Utilization Still Limited?

Despite South Korea’s high EMR adoption rate, inter-hospital data exchange remains inadequate due to three key issues:

1. Lack of Standardization
   • Different hospitals use incompatible data formats and coding systems.
   • Even identical test results may be recorded differently, hindering interoperability.
2. Fragmented Systems
   • Multiple initiatives exist, such as the Clinical Information Exchange and Health Information Highway, but they are not fully integrated, reducing their overall effectiveness.
3. Insufficient Incentives for Hospitals
   • With no clear financial benefits, many hospitals lack motivation to participate in data-sharing efforts.

Despite the abundance of medical data, a fragmented structure prevents it from being effectively leveraged.

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Building a Framework for Seamless Data Exchange

The SNUH study proposes a KR Core-based interoperability framework to facilitate secure and efficient data exchange. The report outlines three core strategies:

1. Establishing a Unified Core Exchange System

• Benchmarking global models (e.g., US ONC, TEFCA) while tailoring the system to South Korea’s needs.
• Adopting FHIR (Fast Healthcare Interoperability Resources) to establish standardized data exchange protocols.
• Consolidating scattered initiatives, such as the Health Information Highway and Clinical Information Exchange, into a cohesive national network.

2. Strengthening Governance for Interoperability

• Merging existing healthcare data committees into a centralized agency to oversee standardization.
• Introducing a pre-approval system for all healthcare IT projects to prevent redundancy and align with interoperability objectives.
• Fostering collaboration between government and private sector stakeholders to enhance technological advancement.

3. Incentivizing Healthcare Providers to Participate

• Financial incentives for hospitals that actively share clinical data.
• Compensation for data providers, where institutions offering high-quality medical data receive financial rewards.
• Subsidies and tax benefits for healthcare providers that comply with interoperability standards.

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HIRA’s e-Form System: Short-Term Optimization & Long-Term Integration

The Health Insurance Review and Assessment Service (HIRA) operates an e-Form system that allows hospitals to submit standardized medical records for insurance claims and reimbursement. However, its functions overlap with the proposed KR Core-based interoperability framework, raising concerns about redundancy.

A two-phase approach—short-term optimization and long-term integration—can address this issue effectively.

1. Short-Term: Improving e-Form Usability for Hospitals

• Currently, hospitals manually enter data into e-Form, increasing administrative burden.
• Integrating KR Core with e-Form would allow automatic data submission, minimizing duplication and reducing hospital workloads.
• Aligning e-Form with existing reimbursement policies will prevent conflicts and facilitate adoption.

2. Long-Term: Integrating e-Form into KR CDI for a Unified System

• Ultimately, e-Form should merge with the KR CDI (Core Data Interoperability) framework.
• HIRA’s role should evolve from claims processing to active management of healthcare data quality and interoperability.
• Transitioning e-Form to a FHIR-based real-time exchange system will enable seamless, automated data flow between hospitals, insurers, and public health authorities.

In summary, short-term improvements should enhance usability, while the long-term goal is full integration into a standardized national data ecosystem.

 

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Conclusion: Interoperability Is No Longer Optional

Medical data is not just documentation—it is a critical factor in patient safety and care quality. Efficient data exchange enables faster diagnoses, reduces unnecessary tests, and improves care coordination. Patients should not have to manually transfer their medical records in a digitally connected era.

Interoperability is no longer an option—it is a necessity.
To drive patient-centered innovation, immediate action is needed to implement these strategies and build a seamless national healthcare data network.

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References

1. Study on Strategies for Enhancing Healthcare Data Interoperability, Seoul National University Hospital, 2024.
2. The Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services.
3. TEFCA - Trusted Exchange Framework and Common Agreement, The Sequoia Project.
4. Quality and Outcomes Framework (QOF), NHS England.
5. My Health Record, Australian Digital Health Agency.
6. Sundhed.dk - The Danish eHealth Portal.
7. Medicare and Medicaid Promoting Interoperability Programs, Centers for Medicare & Medicaid Services (CMS).
8. Fast Healthcare Interoperability Resources (FHIR), HL7 International.
9. Overview of HIRA’s e-Form System, Health Insurance Review and Assessment Service (HIRA).

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Final Thoughts

Enhancing healthcare data interoperability is essential for modernizing South Korea’s medical system. The proposed strategies—establishing a unified framework, strengthening governance, integrating e-Form, and incentivizing hospital participation—will create a seamless, patient-centered healthcare ecosystem.

The time to act is now.
Healthcare leaders, policymakers, and technology experts must collaborate to bring this vision to life.