Healthcare Integration Troubles: The Failed Promise of EHRs and Interoperable Solutions

Abhinav Shashank
Tue 03 Oct 2017
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Healthcare records are a valuable resource for the healthcare industry because of the information they contain. The ones predominantly in use today are the electronic health records or EHRs. They are stored with, at the very least, lab results, diagnostic imaging results, and hospital visits. If a care provider’s office is hooked into the regional EHR, then care provider visits will come up as well. If a hospital uses electronic charting, all of the records from a hospital visit (vital signs, blood sugar levels, assessments, etc.) will also be on it.

The EHRs were implemented to serve two primary purposes of giving easy access to patient medical records and keeping those records private. As more time passes with the majority of the population being on an EHR, data will become more and more meaningful to healthcare providers and patients. Their functionality can even go beyond that of just simple data storage. EHRs can even provide administrative office support and address physicians’ workflow needs by offering transcription services, mobile and tablet accessibility, and tailored specialty forms.

The challenges with using EHRs

Most hospitals have their own unique EHR databases that are set up to be accessible from every computer. However, every EHR format differs from one manufacturer to another, and the trouble is that not every format is readable on every system. In case, providers in different ACO networks need to exchange patient information for meaningful use; there are only so many ways they can get the files across.

Unfortunately, many people outrightly reject the practice of using EHRs because of the technical difficulties that might come with it. Most physicians and hospitals refuse to implement them, and complaints abound like high costs, weak interoperability, low functionality, safety and liability risks, etc. The success of an EHR implementation also depends on the locality of practice. For instance, it is much harder to connect to systems in rural sites within the same network! On top of that, functionality issues such as slow processing, user-hostile formats, and limited capabilities can further deter hospitals from using EHRs.

The inability of EHRs to communicate well with each other becomes a barrier to the transparent communication of health information that is essential for providing quality care. Poor interoperability not only prevents proper coordination of care on a small scale but also hinders PHM on a larger scale.

Optimizing the use of EHRs with health IT

Many would question the very idea of enabling interoperability in systems that are currently in use, hoping instead for universal standards to be made mandatory. However, that would lead to a complete overhaul of the systems. New EHRs will have to be implemented with the mandatory formats, which would result in more expenditure on the part of physicians and hospitals. A strategic yet, radical change like that would be slow to come by and perhaps will take its own sweet time to settle in with the rest of the industry that is still undecided upon EHRs in the first place. Therefore, in important matters such as those concerning the healthcare of millions, the best thing to do would be to exercise caution.

There is an old expression that is often repeated but seldom put into practice: ‘Make do.’ It means that with whatever you have, make the highest and best use of it. To contextualize this adage in healthcare, it means that despite the struggles encountered with EHRs, we can achieve full connectivity for a transparent flow of information with the help of technology. For this reason, the role of health IT is significant for the optimization of EHRs in healthcare.

Health IT solutions can assist in leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. Interoperable EHRs can enable better workflows, and reduce ambiguities by allowing the transfer of information among systems and stakeholders of health care. With EHR interoperability, the ultimate goal, which is improving the delivery of healthcare, would be achieved. Healthcare will improve the quality of care by making the right data available at the right time to the right people.

Enabling interoperability in EHRs

For whatever reasons that may be, the U.S. healthcare failed to generate a market demand for robust interoperability from the start. Now, there is no time for “do-overs” but a dire need to retrofit interoperability into existing systems. Enabling a direct exchange of health data amongst providers instead of paper copies has the following benefits:

  • Saves time – Real-time data exchange reduces the time-taken in the delivery of care thereby making the whole process faster and more efficient.
  • Facilitates care coordination – Transparent flow of data makes it legible, clear and authorized for all providers.
  • Cuts down risks – EHR systems that communicate well reduce the possibility of miscommunications which could lead to malpractice.
  • Increases efficiency – Everything is electronically stored and does not need to be filled out over and over again.
  • Avoids unnecessary tests – It reduces the chance of redundant testing and procedures by a large margin.

Over and above this, the meaningful exchange of patient health information relays accurate information to the care teams for a well-informed, coordinated and patient-centered care. Interoperable EHRs thus, play a crucial role in improving the cost, quality and patient experience of health care.

A sense of urgency is attached to making all EHR systems interoperable for effective communication amongst provider. That’s because, despite considerable investments in health IT, the advancement of electronic information sharing across systems has been slow. Something that is so fundamental to the success of EHRs has been left out of the center-stage of a value-based ecosystem for too long.

Concluding remarks  

To realize their full potential, EHRs must be able to share information seamlessly and an interoperable health IT environment makes this possible. Interoperability will allow physicians and hospitals to share patient’s health records in real-time. Providers, patients, and insurers all benefit from increased access to patient’s health information.

For interoperability to gain wider prominence in healthcare, there needs to be a push from the policymakers and their encouragement will trickle down to the vendors and providers who will be more keen on making EHRs truly interoperable. The same kind of monetary incentive and promotion that fueled the adoption of EHRs needs to happen for interoperability to bring its importance into the limelight. The actual issue is rallying all the stakeholders of healthcare to form a consensus on the acceptance of interoperability for the better future of value-based healthcare.


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Tags: Healthcare, Integration
Abhinav Shashank
Healthcare Integration Troubles: The Failed Promise of EHRs and Interoperable Solutions

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