Interoperability remains a top challenge for hospitals — so much so that it was cited in the HealthcareIT News 2016 EHR Satisfaction Survey as a top issue. The lack of interoperability causes hospitals to be inefficient and causes duplicate work for clinicians. It may be time to start looking outside of the EHR to make interoperability between systems happen.
Many factors have contributed to the interoperability problem. Patients now have even more options for their care than ever before, coupled with the fact that there are more technology systems that hold this information (HIEs, EHRs, 3rd Party Specialty systems etc). As a result, the clinicians job of caring for, and diagnosing, patients is exponentially harder than it used to be.
Complexity, confusion, and difficulty is not the intent of having all records and systems become electronic. We’ve got to be able to provide the clinicians with ALL of the patient data that they need, when and where they need it.
I would like to share a couple scenarios with you of how some hospitals are solving the interoperability problem and the impact that it can have on clinicians and patients.
Having access to HIE data can reduce unnecessary medical procedures
A recent study reported by Healthcare Informatics shows that HIEs can reduce redundant and unnecessary medical procedures by giving physicians instant access to patients’ current medical histories. Wow – this is great news! Why doesn't everyone see this benefit as a reality?
There are many answers to that question. One example is: We’ve talked to a lot of hospitals that are connected to their state HIE, and for a lot of varying reasons, these hospitals don’t utilize the data from the HIE regularly to care for patients.
Some challenges for the hospitals include:
- having to toggle between their EHR and HIE to get the information that is needed (which requires separate log-in credentials etc)
- not knowing what data is available in the HIE
- not having time to check the HIE for patient data
We recently worked with one HIE that wanted to solve these challenges for their participants. We helped the HIE implement a solution which now alerts the clinicians when new data is available in the HIE, and gives them detailed information that they need (Care Alerts, Notes etc), right in their EHR.
This now gives the clinicians the information from the HIE that they may not have had before, and hopefully, like the above study claims, will reduce redundant and unnecessary medical procedures.
Clinicians looking for ways to make their jobs easier and more efficient
Healthcare Informatics reported a study by the University of California San Francisco Medical Center that said 80% of progress notes are copied and pasted. The report goes on to say that "copying or importing text increases the risk of including outdated, inaccurate or unnecessary information, which can undermine the utility of notes and lead to a clinical error.”
In yet another report, NIST (cited in the same Healthcare Informatics article) shared its findings on a "copy and paste" usability study stated: “Copy and paste functionality is intended to allow medical practitioners to easily and efficiently reuse information in patient EHRs without having to retype the information. However, in practice, current implementation of this functionality has introduced overwhelming and unintended safety-related issues into the clinical environment.”
So, it is clear that there is a lot to be done to improve processes, procedures, and technology to help clinicians do their job better, faster, and more importantly to improve the safety of the patients.
I think the better solution is to have the data available when it’s needed, without having to duplicate it again and again. And have the data available where it’s needed for the clinician, so they don’t have to take the time to search in other systems for data that may or may not be there.
This has already been done with several hospitals by either alerting them that data is available in other systems for them to look at (eliminating the need to duplicate it), or by passing specific information from the EHR into another system. In this short video example, certain diagnosis codes were passed to a 3rd party system for charge/capture purposes. It can also work in reverse, where you can bring important patient data back into the EHR, if desired.
The moral of these scenarios is that we need to start looking at getting access to patient data differently, and stop doing the things that take up time and resources, that don’t give the clinicians the data they need.
If you would like to see more examples of how to easily access patient data in other systems, you can view these short videos.