Last week, Epic announced a new product that caught the eye of many in the industry. Share Everywhere allows patients to open their medical records to any provider with internet access, regardless of whether they have an EHR.
It's an interesting development that has key interoperability implications. The issue of data access and exchange has been a historic challenge that's been pushed more into the healthcare industry's limelight since Meaningful Use requirements were passed in the 2009 HITECH Act. Many providers place blame on vendors. Companies have been accused of everything from information-blocking to misrepresenting software capabilities.
Still, vendors have been slowly pushing toward interoperability with efforts like The Sequoia Project's Carequality project, a public-private collaborative that promotes interoperability. What makes Epic's news provocative is the way it places more of an emphasis on patients' ability to control their records. Personal health records (PHRs) that rely on patients maneuvering data haven't always played in vendors' favor. Google experienced the sting of dulling stickiness with its Google Health personal records product before putting it out to pasture.
The question over a patient's willingness to engage with a portal product is the reason President and CEO of Massachusetts eHealth Collective Dr. Micky Tripathi told Healthcare Informatics the company doesn't see Share Everywhere as a large driver of interoperability, though he sees it as a "great, incremental addition to functionality, and it [continues] what Epic has already been doing, which is contributing a lot to interoperability growth across the U.S."
"It also pushes the market a bit more; it’s another example of the market to say, here is another incremental step forward to putting more power in the patients’ hands — and that’s a good thing for everyone," he told Healthcare Informatics' Rajiv Leventhal.
To get a better sense of the product, Healthcare Dive caught up with Sean Bina, VP of access applications at Epic. Here are two takeaways from our conversation.
1. Epic sees patient portal adoption rising, and believes the trend will continue
Epic has seen a huge increase in MyChart adoption over the past few years, Bina said, adding the company is about to close in on 68 million patients with lifetime MyChart accounts. "We see [the increase] not only for the direct patient use but also from a proxy standpoint," Bina said.
Bina said that adoption is helped through a couple of different channels. For one, Epic attempts to make the sign-up process easy, and MyChart is able to be downloaded as a native app on smartphones. Bina also believes features that go beyond messaging physicians, such as reviewing their healthcare goals, documenting advanced directives, setting up payment plans or signing off on consent forms through the portal help create a stickiness for the product.
For another recent example, Mayo Clinic announced last week it will offer a symptom assessment tool through MyChart.
"What we'll see over the next few years is . . . we'll move from portal adoption being fairly episodic to it being embedded in the fabric of patient's lives," Bina said.
That's a big bet, but the hope is as the digitization of healthcare continues, patients will actively engage with their own record-keeping to assist their care plans. "I'm excited about patient-driven interoperability," Bina said.
2. The need for social workers to receive healthcare information helped drive the use case for Share Everywhere
Vendors such as Epic are seeing a need to share health data outside of traditional healthcare institutions. Bina said provider-to-provider interoperability is readily capable. About 2 million records move around on Care Everywhere on a daily basis, according to the company.
However, there were some use cases where patients weren't able to communicate their information to a caregiver, and these helped underscore the development for features such as Share Everywhere. One example: sharing immunization records with a school nurse. Bina looked to these edge cases where providers may not have an interoperable EHR — such as a hospice, a mental health setting or even a food pantry — as areas where patients' ability to share their information may help.
"There are all these different intersections between social care and healthcare," Bina said. "[With] healthcare-to-healthcare, we often have two interoperable EHRs which can communicate to each other but [with] healthcare-to-social-care we don't."
"We can't expect the caregiver on the other side to have that same sort of interoperability, so we want to target that and make it possible for patients, as appropriate and under their control, to be able to share their information," he added.
The goal of Share Everywhere, he said, isn't to replace the needed interoperability through EHRs, but to extend capability to where a caregiver may not have an EHR.
Bina said he expects, with the other big EHR vendors, the industry will be interoperable through Carequality in the short-term future, but hopes that with features such as Share Everywhere, greater strides will be made to help patient-driven interoperability.