The path to EHR interoperability is no clearer today than it was when medical records began transitioning from paper to digital files. That delay has left physicians frustrated, policymakers baffled and vendors making more promises than progress for better data exchange.
It’s clear there is no one solution, but rather a confluence of issues that can lead to greater interoperability. But that provides little solace to practicing physicians seeking better use of EHRs and greater access to shared patient records.
The national project to make disparate electronic health records (EHRs) interoperable—that is, able to exchange patient information easily with one another—has largely stalled in recent years. As a result, far less clinical data is moving among providers today than policymakers expected in 2009, when the federal government launched its ambitious campaign to incentivize the adoption of EHRs by physicians and hospitals.
“We’ve spent nearly $40 billion on EHRs in the U.S., yet we continue to not have a high level of interoperability and information sharing, and that’s where most of the value of EHRs is derived,” says Janet Marchibroda, MBA, director of the health innovation initiative for the Bipartisan Policy Center, a think tank in Washington, D.C.
Here’s why interoperability remains an elusive goal, what the latest technology offers and what physicians can do in the meantime.
What doctors want
Surveys show that the majority of doctors believe that exchanging health information with other providers could help them deliver better care. But they don’t want to spend time searching for the information; they want it delivered to them.
For example, Kenneth Kubitschek, MD, an internist in Asheville, North Carolina, believes that with true interoperability, anytime something relevant was done for one of his patients anywhere, data about that service would flow automatically into the correct fields in his EHR.
But observers say we’re still a long way from that.
“Even getting information to flow from organization to organization is a big undertaking, and it’s been hard to achieve,” notes Julia Adler-Milstein, Ph.D., an associate professor in the School of Information at the University of Michigan. “There’s a lot more to do to get the right subset of information to the provider at just the right time.”
There is no silver bullet to achieve full interoperability, experts agree, but a major step forward will be the widespread implementation of new apps that can be plugged into EHRs and used to transfer health information.
Meanwhile, some providers will continue to use health information exchange organizations (HIEs) and/or a nationwide secure messaging protocol to trade patient data. Some observers believe that the new app standards will allow patients to download their records from multiple providers in one place so they can give their physicians access to the data.
Experience on the ground
Most primary care physicians see value in having access to more and better health information from other providers. But at present, they say, they often lack timely access to important data from other doctors, labs and imaging centers.