Now that nearly 75% of physicians are using certified electronic health records (EHR) systems (according to a 2015 report by the Office of the National Coordinator for Health Information Technology), a significant amount of patient data is being captured and stored electronically. Yet all too often, transmitting this data from one provider to another requires phoning other providers, faxing paper records, asking patients to deliver paper records or sending records by mail. In many cases, doctors do not find out when their patients visit another provider or what the results of the visit are. For patients, visiting different providers often means having to fill out the same forms, answer the same questions and sometimes even take the same tests again.
When patient health information is divided between different platforms that do not communicate with one another, providers can find it hard to understand their patients’ entire stories. This can be more than just inconvenient and inefficient; it can be dangerous.
This is why our healthcare system needs interoperability.
What is interoperability?
Interoperability refers to the ability of healthcare IT systems and medical devices to work together and share patient health data.
Ultimately, interoperability has the ability to improve healthcare outcomes, reduce medical errors, facilitate patient engagement and population health initiatives, enable the practice of true coordinated care and lower healthcare costs in the US by a projected $30 billion annually (according to a report by the West Health Institute). It is also a key component in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), so providers’ ability to achieve interoperability at their practices may impact their Medicare reimbursements.
The US healthcare system has a long way to go before widespread interoperability will be a reality, in part because universal standards for data sharing have yet to be developed. However, cutting-edge healthcare IT vendors are already implementing interoperability capabilities in their systems, and you can take advantage of this at your practice.
How can I harness the benefits of interoperability at my practice?
- Talk to your EHR vendor, as well as competing vendors, about interoperability. Your practice’s ability to achieve interoperability and practice coordinated care largely depends on having the right EHR system. However, 69% of physicians find that their EHRs hurt their ability to practice care coordination rather than helping it (according to a national survey by MPI Group and Medical Economics). Ask vendors what interoperability capabilities they currently offer and how they will expand these capabilities in the future. A good vendor should show a strong commitment to delivering robust, secure interoperability and express willingness to work with you on system integrations. If your vendor doesn’t make interoperability a priority, you may want to consider switching EHRs.
- Use an EHR that is cloud-based rather than server-based. When your patient data resides securely in the cloud rather than being tethered to an onsite server, it is much easier to enable data sharing with other practices and providers.
- Make sure your EHR captures structured data rather than free text. Not only does this make exam documentation simpler for providers, but it also means that the data they capture can be exchanged in a meaningful way with other providers. A large proportion of EHR systems today do not offer this functionality, but structured data can be critical in achieving system interoperability.
- Check whether your EHR vendor complies with basic interoperability certifications and standards. These include HL7 compliance, application programming interface (API) functionality, ONC-ATBC Certification for Meaningful Use (which features interoperability criteria) and the ability to produce or digest CDA outputs (CCD, CCR) based on HITSP Standards. These capabilities have been standard within the industry for years, so if your vendor does not meet them, it may be a red flag that your vendor is not committed to interoperability.
- Find out what advanced interoperability capabilities your vendor provides. A good vendor should go well beyond following the standards above; they should offer more mature, efficient interoperability that addresses the bigger picture. Interoperability is not just about what data can be moved, but how it is moved. Focusing on the “how” is necessary for ensuring that providers’ and patients’ disparate health data can be consumed and made available in a useful way, both for data coming in and for data going out.
- MACRA has mandated that the Office of the National Coordinator for Health Information Technology (ONC) establish MACRA interoperability measures by July 2016. When these measures are released, ask your EHR vendor about their plans for ensuring compliance. Once MIPS payment adjustments take effect for Medicare reimbursements, you could have to pay penalties if your EHR is unable to meet the interoperability requirements under MACRA.
- If you’re not satisfied with the interoperability capabilities your EHR vendor offers, you may want to consider switching to a more interoperable system. Switching may sound like a difficult and risky process, but the good news is that many EHRs today offer powerful data conversion tools that can migrate patient data from one EHR system to another. This can allow you to begin enjoying the benefits of interoperability much faster than you may expect.
- Once your practice has strong interoperability capabilities, discuss interoperability with your patients. Many patients want their medical records to be accessible anywhere, so explain that interoperability allows their health data to be exchanged with other providers more conveniently. Let your patients know what capabilities your practice offers and how they can benefit, and encourage them to ask questions. If your EHR offers a patient portal, encourage patients to use it to review their records. Having this conversation helps patients become more informed and engaged in the healthcare process. Plus, it demonstrates that your practice is on the leading edge of healthcare IT, which reinforces your commitment to delivering high quality care.
To read a recap of a conversation with industry leaders on this topic, click here.