Interoperability and HIE

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Why Physicians Still Don't Have Access to Patient Data from Systems Outside Their EHR

Written by Laura Hankins, Product Director for Clinical Workflow Solutions, Iatric Systems | @

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It's 2018, a time when there is an endless amount of information available, multiple technologies to choose from, a 24/7 news cycle, and access to any type of information, in seconds, at your fingertips. (Or, actually, without even having to use your fingertips at all — you simply have to say out loud what you want to know!)

Here are some examples: Want to know the requirements for growing a Japanese Maple? You can instantly get the answer. Want to know how many calories are in a chicken breast? You can instantly get the answer. Want to know how to convert inches into centimeters? You can instantly get the answer. Want to have your physician know about your visit to another hospital while you were on vacation? You can...oops, not instantly get the answer. Bummer.

It seems that, for the things that really matter, like your health and medical treatment, we are still fighting an uphill battle.

We all know that interoperability between systems has been the holy grail that hospitals, physicians, and organizations have been striving to reach for several years now, yet why is it so difficult to achieve?

Here are some of the top challenges:

1. Meaningful Data: It's not just about "connecting" the systems, and transferring data — it needs to be meaningful data. Data that resides in two different systems, the majority of the time, is going to be different in some way. And therefore, simply transferring data from one to the other is meaningless.

This is evidenced by the recent Black Book Survey which reported that: 

"Twenty-seven percent of medical record administrators report the transferred patient information was not presented in a useful format, which surprisingly increased by five percent vs. 2017, indicating a slip in improvement efforts."

2. Time: Physicians don't have time to search other systems for data (which may not even be there), while they are caring for a patient.

According to the same Black Book Survey,

"Sixty-two percent of­­ hospitals aren't using patient information outside their EHR in Q1 2018 (according to surveyed clinicians) because the external providers' data is simply not available in their EHR system's workflow."

3. Financial and Technology Know-How: Hospital budgets are already tight, so investing in yet another solution to solve this challenge may be difficult, unless it really provides exceptional value. And, finding the right technology expertise to have in house is also difficult.

From the Black Book Survey:

"In 2018, 57 percent of hospital network physician practices operating on assorted EHRs report they continue to lack the financial and technical expertise to adopt complex interoperability which are compulsory to attain higher reimbursements built into value-based care initiatives by both public and private payers," said Doug Brown, managing partner of Black Book Research.

So, how do you overcome the infrastructure, the workflow, the financial, and the technology hurdles to solve this problem?

The answer is, it's not a one-size-fits-all solution. That is obvious just from the sheer magnitude of the differences between systems that got us here in the first place.

It's going to take solutions that take into account the specific needs of each organization, the right technology to transfer the right data, at the time that the physician needs it, and in the right format so they can do something with it.

It's actually not impossible. We've done this with several hospitals and they are now doing things like: 

  • Using patient data that is available in the HIE because they are alerted when new data is there for their existing patient
  • Automatically checking and bringing demographic information into their main EHR from other systems
  • Automatically querying outside systems for patient data from within their existing workflow
  • Automatically bringing patient specific data from outside systems back into their EHR

Check out this video from one hospital that is providing their clinicians data from their state HIE, within the clinicians' existing workflow. It's a step in the right direction.

What are your top priorities in 2018 to work toward solving this interoperability challenge for your organization? Leave me a comment below!

 

Topics: Interoperability, EHR Optimization, EHR Satisfaction, patient data, EHR Workflow

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