Report shows most hospital interoperability efforts aimed at transmission, not usability
- Hospitals have achieved some progress in interoperability, but those efforts have focused largely on finding and transmitting information and not on usability, a new analysis in Health Affairs concludes.
- Researchers looked at a cohort of hospitals from 2014 to 2015 to see how they improved on four interoperability measures: finding, sending, receiving and integrating electronic patient information. In all, 29.7% of hospitals engaged in all four areas in 2015, up slightly from 24.5% the prior year. The greatest gains were seen in sending and receiving with 8.1 and 8.4 percentage points, respectively.
- Just 18.7% of hospitals said they “often” use patient data from outside providers to inform patient care decisions, an overarching goal of public and private interoperability efforts.
As more hospitals adopt EHRs and other digital technologies, data sharing is more important than ever. Legacy EHR vendors have begun to embrace open platforms, and 2017 has been touted as the year that could begin to bring significant gains in data sharing and integration among vendors and providers. Last month, Epic launched a new global interoperability platform called Share Everywhere that allows patients to grant access to their personal data to any provider anywhere with internet access, regardless of whether they have EHRs.
In other signs of progress, Surescripts reported a 12% surge in electronic prescriptions delivered over its network last year — up to 1.6 billion from 1.4 billion in 2015.
Meanwhile, the 21st Century Cures Act, passed last December, charges the Office of the National Coordinator for Health IT to create a framework that would allow for greater interoperability between healthcare entities and prods HHS to educate providers about health information exchange. And the FDA passed final guidance on medical device interoperability, paving the way for hospitals and consumers to recognize how specific devices share data.
Policymakers and researchers agree that interoperability across EHRs is crucial to ensuring providers can access patient data from disparate sources when making decisions about treatment and care, the study’s authors note. However, the research shows only those hospitals with comprehensive EHR systems are actually integrating information without manual intervention.
Other barriers to integrating information into EHRs and clinical workflows include not routinely seeking external data for clinical care and not taking full advantage of health information exchange organizations, the authors add. They note that IT infrastructure has tended to focus on moving information between hospitals, rather than on integrating that data.
“A greater policy focus on integration, rather than on sending and receiving data, may help hospitals’ focus to making data available at the point of care when it is clinically relevant,” the authors write. “Hospitals should also assess important ‘last mile’ issues, such as when and where outside data are being used. Low levels of use, which have been found in other studies, should prompt hospitals to examine and address underlying barriers, such as low awareness of HIE capabilities or poor use interface design that makes it difficult to know when relevant information is available.”