Ongoing interoperability challenges

While interoperability of patient health information is advancing in small steps across the industry, challenges remain.

Speaking at the Healthcare Leadership Forum, Howard C. Bauchner, MD, editor-in-chief of the Journal of the American Medical Association, said there is a great deal of interest in improving connectivity.

Evidence-based medicine has experienced substantial improvements, Bauchner said, such as incorporating systematic reviews into guidelines. “We’re just beginning to see the next evolution of guidelines and grading of evidence but “we still struggle in how to take that summary variable and understand how to articulate what that would mean from a clinical standpoint.”

Bauchner said he thinks health IT can help incorporate level A evidence into EHRs. The question, he said, when considering safety, quality, variation, etc., is “how can we create a horizontal view of these issues so there can be progress in health outcomes? The key will be health IT.”

Health IT plus guidelines equals value, he said. “EHRs must become smarter. We have to go beyond scouting and linking databases.”

A survey conducted by the eHealth Initiative found that, despite billions of federal dollars invested in health IT, exchanging patient data between healthcare systems remains a significant obstacle for health information exchanges (HIEs).

Healthcare delivery organizations reported that while information exchange within hospitals’ EHR systems and health networks is routine, they are increasingly challenged by the need to interface with clinical and administrative systems outside of existing networks.

Of the 199 organizations surveyed, three-quarters reported that they have had to construct numerous interfaces between different systems to facilitate information sharing, a process that is both time consuming and expensive. Moreover, 68 organizations have had to build 10 or more interfaces with different systems, according to the survey.

The survey also showed that many HIEs have not yet developed ways to allow patients to enter or view their own data in the health exchanges. Patient engagement services, like tools for managing appointments or prescriptions, are rare, but survey participants predict this may change as patient engagement becomes a critical step for providers looking to receive incentive payments for using EHRs.

How is your organization achieving interoperability? Please share your experience.

Beth Walsh

Clinical Innovation + Technology editor