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The Clinical Divide: Achieving Interoperability Between EHRs

Kevin Campbell, M.D.
FEBRUARY 04, 2019
When electronic health records (EHRs) were mandated, the argument for implementation all over the U.S. was to be able to easily share information between different healthcare systems and different clinical providers. Decades later, these systems still do not communicate well with one another. We’ve talked about the lack of interoperability between EHRs for decades and how we can achieve it. We’ve done this time and time and time again without success. And now, seven leading hospital organizations are putting out a call to arms to advance data sharing and interoperability across the healthcare industry. Physicians and healthcare executives are fed up with the way EHR companies have purposefully made integration between their systems quite difficult — it’s all about money. We must find a way to come together to get the most out of this technology that was designed to be the answer to better patient care and more efficient sharing of information. So, what can we do to get there?

Welcome to The Clinical Divide. I’m Dr. Kevin Campbell, a Duke-trained cardiologist and CEO of the health data startup PaceMate. Every week, this Healthcare Analytics News™ video series examines healthcare technology and medicine’s top news. I bring the views that help physicians and healthcare executives bridge the clinical divide.

 

You know, EHRs were designed to streamline care and allow for interoperability, but that has not been the case at all.  Each EHR provider is striving for a monopoly and little effort has been put into working with its competitors.  While some headway has been made to achieve interoperability over the last decade, we’re still not even close. Providers lack the technology to receive records electronically due to the inability of one EHR system to connect to an API of another EHR system. Health systems have difficulty sending the proper information to a different vendor platform and have trouble matching patient identities. This leads to duplication of patient lists, mismatching and potential erroneous information being exchanged between systems that could ultimately hurt patients. We see interoperability in mobile phones regardless of the make, model or operating system, so why can’t we get  EHRs to communicate with one another?

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The answer to me is really quite simple— everyone is holding back. Epic, Cerner and others are there to make money and they’re not trying to work together to make things better.  

A report released by the American Hospital Association and the Federation of American Hospital, among others, gives insight on potential pathways to achieve this “holy grail” of interoperability. Key concerns that are being addressed by these pathways include the Security and privacy of patient data, creating efficient, usable solutions and creating real standards that support data sharing .

We’re really tired of waiting on the EHR industry, and some health systems have found ways to exchange patient health information in a secure and timely manner on their own — it’s not clean, but it works.  For example, Boston Children’s Hospital works with TriVox Health and Kaiser Permanente — there’s other examples out there. However, until we get real cooperation between EHR vendors, we  just cannot achieve this data exchange on a national level — which we need — due the adoption of different technology and vendor protocols that fail — I believe on purpose — to transfer full data sets. 

Health systems have already invested hundreds of billions of dollars in EHRs and other information technology systems that can record, store and transfer patient data securely. Doctors are experiencing unprecedented levels of burnout due to EHR frustrations. We as CEOs and physicians must continue to invest in the systems that do facilitate interoperability. We need to tell developers and manufacturers that we need this or we need that, and we need to force them to listen.  No longer is it acceptable to simply accept the EHR for what it is. Physicians need to provide feedback that’s honest about what works and doesn’t work in clinical and specific care type situations. Our government must step up and demand interoperability and must support more robust testing, maintain regulatory relief on technology and focus on the growing interoperability of technology, in order for us to provide this for our patients.
 
Thank you for joining me for this episode of The Clinical Divide. Until next week, I’m Dr. Kevin Campbell, for Healthcare Analytics News™.

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