Interoperability among hospitals is improving
The smooth interchange of health information is critical for healthcare efficiency in the United States, and hospitals appear to be inching closer toward improved interoperability across health IT.
Overall, hospital engagement in three domains of interoperability––receiving data, finding data and integrating data––have significantly increased since 2017. That’s according to a data brief from the Office of the National Coordinator for Health Information Technology (ONC) about the state of interoperability among hospitals as of 2021.
ONC has been focused on improving interoperability across the healthcare space for many years, and the agency is tasked with implementing health IT provisions from the 21st Century Cures Act, including the Trusted Exchange Framework and Common Agreement (TEFCA) and Information Blocking provision. TEFCA aims to enable nationwide exchange of electronic health information across health information networks (HINs), while the Information Blocking provision refers to business, technical and organizational practices that prevent or materially discourage the access, exchange or use of electronic health information (EHI).
According to the brief, 6 in 10 hospitals engaged in key aspects of information sharing and integrating of summary of care records into EHRs. That’s a 51% increase from 2017 and a big improvement on ONC’s goals. In particular, availability and usage of electronic health information received from outside sources at the point of care significantly increased over the last four years––62% and 71%, respectively, in 2021.
About 80% of hospitals electronically queried or found any patient health information in 2021. Since 2017, rates of integrating summary of care records showed the biggest improvement, increasing 21% by 2021. Finding information also increased 19% since 2017.
While the brief revealed a positive trend toward interoperability and improvements in several areas, there were still some discrepancies between hospital types in the report. For instance, rural and small hospitals were behind their counterparts in engagement between 2017 and 2021.
“Rural and small hospitals’ rates of having information available at the point of care increased by over 26% reaching 48% in 2021, and nationally it grew over 20%, reaching 62% in 2021,” ONC stated. “Additionally, usage of information received electronically from outside sources by rural and small hospitals increased at twice the rate of hospitals nationally (over 40% vs. over 20%) between 2017 and 2021. Yet, these less resourced hospitals are still not on par with their counterparts, indicating the need to continue addressing challenges with having full access to electronic information from external sources.”
The brief also noted that the increase in interoperability could be attributed in part to the initial implementation of health IT provisions from the ONC Cures Act Final Rule.
In 2021, hospitals were using more methods to improve interoperability, including more methods to send (3.8 out of 7), receive (2.9 out of 7) summary of care records, and find (2.7 out of 6) patient health information. Health information services providers (HISPs) and health information exchanges (HIEs) were the most commonly used electronic methods for sending and receiving information, with the use of HIEs and interface connections with EHRs were the most commonly used methods for finding patient health information.
Another 4 in 10 hospitals continued to participate in multiple networks, which may be due to challenges with exchanging information across different networks. TEFCA’s policy aims may help improve this need for different networks by establishing a “universal policy technical floor for nationwide interoperability and simplify connectivity for organizations to securely exchange information,” ONC said.
See the full data brief here.