HCI-DC 2014: Executives share urgency for interoperability

“Americans would be surprised the degree to which treatment took place in the absence of relevant information to deliver treatment,” said Michael H. Schatzlein, MD, Tennessee/Indiana ministry market leader of Ascension Health and CEO of Saint Thomas Health, speaking during a panel discussion at Health Care Innovation Day on Feb. 6, a joint Office of the National Coordinator for Health IT and West Health Institute event.

At Saint Thomas Health, achieving interoperability for better care is particularly daunting, he said. In this Nashville-based system, “1,600 physician offices, not employed with us, have to be integrated and navigators also need to be integrated,” he said. “We’re living in a dangerous world because we’re part electronic, part paper and sometimes the information is not congruent between paper and electronic.”

Integrating systems comes at a heavy cost, said Stephen Jones, CEO of Robert Wood Johnson University Hospital in New Brunswick, N.J. “The costs of interfaces are huge, both the time and the money. That time and that cost are preventing the transformation.”

Integrating systems requires more than just moving information. “It’s not just about getting information, you have to read it, understand it, and the nurses and doctors have to use it.”

Jones said plug and play is the answer, but said software systems focus on costly interfaces. “We spend million and millions on interfaces. If we set standards and focus more on plug and play, we take out a whole layer of costs and we can still use the same great team of vendors.”

Jones said there is an opportunity for hospitals and health systems to use their buying power to drive interoperability by requiring developers to use open standards. “There is an opportunity for vendors and government partners to jump on this issue. It is really important that all sectors are engaged.”

Getting information to flow to support population health remains an obstacle as providers use a wide range of vendors, said Michael Johns, MD, chairman of the Center for Medical Interoperability. Bringing together vendors, developers and hospitals to develop data standards will help solve these issues and, ultimately, benefit patients.

In his discussions with the CMIO community, Schatzlein said many still believe that large EMR vendors are reluctant to provide information to allow providers to tie into their platforms due to business interests.

Looking at the $30 billion in government investment in health IT and EHR adoption, Johns said more should have been done at the start to develop interoperable platforms.

“We missed an opportunity to start where patients would benefit the most by having free-flowing data across systems. But, we are where we are,” Johns said.  

With this investment in taxpayer dollars, he said there is no time to wait to get the interoperability issues solved. “We need to get on this. We have to move, otherwise we are letting down the next generation that will come after us.”

“Our patients are waiting,” he added.