For years, medical professionals have complained that electronic health records (EHRs) are difficult to implement and fraught with interoperability challenges. Envisioned to make communication between health providers simple, coordinating EHR data has proven to be a complex task.
Federal officials largely place blame at the door of EHR vendors, who received federal stimulus incentives to develop health information technology (HIT) software that digitizes medical records. A recent report from the Office of the National Coordinator (ONC) documents the industry’s accusations that HIT vendors have made it too difficult for hospitals and clinics to share patient data with other facilities that use different EHR software.
Health providers allege that vendors hinder sharing of patient records by requiring use of proprietary platforms, charging excessive data connection fees, and making it difficult for providers to switch systems. Health records often exist in silos, with physicians having to print or scan reports to share patient data across systems.
The ONC report was requested by Congress to investigate whether the $30 billion digitization movement has created a windfall for IT and health companies without meeting the goals outlined by the program: Improve quality of care and reduce costs through information sharing.
Blame is also cast on health networks in some regions, with rival systems or independent physician practices alleging that some systems control referrals and enhance market dominance by making it difficult to transfer patient records outside their network of facilities.
For the most part, however, providers support the digitization initiative. The Department of Health and Human Services is currently overhauling meaningful use guidelines in response to requests from major health organizations including the American Medical Association and the American Academy of Family Physicians. The ONC has also released corresponding revisions to the HIT certification criteria.
New guidelines aim to foster collaboration and innovation and give providers more flexibility in meeting interoperability standards, though some providers believe the revisions don’t go far enough.
HIT vendors including Athenahealth, McKesson, and Cerner are also taking steps to correct the problem. About 70 percent of EHR vendors have joined the CommonWell Health Alliance, which aims to create a nationwide data sharing network. Through the CommonWell platform, vendors can create one interface that gives all clients access to the records of all participating vendors and providers. However, one major vendor, Epic, is resisting the project, and universal collaboration among HIT vendors may be necessary to achieve true interoperability.
Vendors must also overcome resistance from practitioners that find EHRs cumbersome to use and counterproductive to patient care.
In some regions of the US, EHR systems are running smoothly due to early-adoption standards that have given them years to perfect the information-sharing practice. Countries abroad with established EHR programs have also found meaningful use.
Industry Impact: To achieve meaningful use of EHRs throughout the US, health care providers must work together to create easily accessible patient records. Vendors must also be vigilant in making sure that all EHR systems speak the same language.