How is interoperability important for the future of EHR adoption?
According to the Office of the National Coordinator for Health Information Technology, interoperability is crucial to the future success of electronic health records. The ability for an EHR system to enable the sharing of health information between physicians and their patients is a major aspect of increasing the adoption of the system on a nationwide level. The ONC recently emphasized the importance of interoperability in a report to Congress, stating that effective interoperability may stretch beyond the success of EHRs and apply to the future of all health IT in general.
A team effort
Joseph Frassica, M.D., vice president and chief medical information officer of Philips Healthcare said that EHRs must team with other connected medical devices that are commonly used by physicians to monitor patients, share information about their clinic and other useful tools for practices, according to EHR Intelligence. Frassica pointed out that these medical devices have been successful at pushing data into EHR technology, but have not seen EHR systems do the same for them.
"In order to actually harvest the great potential benefit that the federal government and the people of the United States have invested in automating healthcare through the electronic medical record, interoperability needs to be a two-way street," said Frassica.
According to Frassica, EMRs are constantly receiving device data, but now this data is locked inside what has become an isolated pit of information. This does not work, as there are more than simply a couple of organizations that can use the data provided for patient care. According to EHR Intelligence, innovation of this data is currently limited to a few major organizations.
How poor interoperability impacts ACOs
Interoperability is an extremely effective aspect of EHRs. However, just as effective interoperability can significantly benefit an organization, a poorly functioning system can create a massive barrier for accountable care organizations, according to a recent survey from Premier and the eHealth Initiative that focused on 62 ACOs and the impact that poor operability had on them.
Every ACO in the study that responded to the online poll said that one of the biggest struggles for their organization is retrieving access to data from external sources. Problems like these can ultimately have very negative effects on the company in the long run, hindering costs and the quality of future improvements.
These organizations are equipped with the technology to enhance clinical quality. The most frequently used are EHRs, accounting for 86 percent of organizations, as well as disease registry, data warehouse, health information exchange and clinical decision support. However, the technology used for distance-based medicine was not found to be as commonly used, as a mere 38 percent used secure messaging, 36 percent relied on referral-management tools, 34 percent provided phone-based telemedicine and 26 percent used video-based telemedicine. This ultimately triggers worries regarding the capability of rural ACOs to leverage health IT to properly monitor remote populations.
"Even when ACOs have successfully adopted and merged HIT systems, they aren't able to effectively leverage data and analytics to derive value out of their investments," Keith J. Figlioli, Premier's senior vice president of health care informatics and member of the ONC's Health IT Standards Committee, said in an announcement last month.
Some of the study's additional significant findings include that a total of 88 percent of the ACOs struggle with the incorporation of data from different sources, while 83 percent deal with major obstacles in integrating analytics into workflow. In fact, the interoperability between various systems was a big challenge for approximately 95 percent of ACOs.
Meanwhile, more than 90 percent of participating organizations reported that the cost and return on investment of health IT was a key barrier to further implementations. The lack of successful interoperability is likely responsible for this barrier. There was also a reduced ability to leverage system infrastructure to support care coordination, population health management, patient engagement and quality measurement.
