EHR Interoperability : The growing mandate in healthcare industry

What is EHR Interoperability

Grace is a citizen of Australia and she has visited India for her heart valve replacement surgery due to high treatment costs and long waiting period in her home country. She checked into one of the reputed hospitals in Delhi. She got admitted to the hospital and her surgery went smoothly. After recovery, she gets her discharge papers. She now asks the doctors to share all her test reports to share with her at-home care team. Is this possible? Will the doctors be able to deliver what Grace asked for? This is when we talk about EHR Interoperability.

This is only possible if the hospital has implemented a robust Healthcare IT system which enables EHR interoperability. It enables better workflows and reduced ambiguity, and allows data transfer among EHR systems and health care stakeholders. Ultimately, an interoperable environment improves the delivery of health care by making the right data available at the right time to the right people.

Why is it important? A few benefits of EHR Interoperability are listed as below:

1. Improved efficiency: No matter what the data source is, if the data is presented on a consistent basis, it is easier for practitioners to get to the core of the issue and accordingly make informed decisions for treatment.
2. Safer transitions of Care: If a patient is on vacation and falls ill suddenly, he may not be able to provide all details of his medical history.This will make a lot of difference to the doctor who is responsible for his treatment. Hence interoperability ensures safer transitions of care in terms of sharing all his medical history details.
3. Helps in lowering costs: Interoperability can help in sharing information in a timely manner. If you have done a blood test last week, and the same is required today, it will save time and money by reducing the unnecessary tests at the hospital.

The current Update

There has been a substantial increase in electronic health record adoption across the world however the movement of patient data across the world healthcare facilities has not developed yet. Still today, essential pieces of information are often missing or cumbersome to access. Patients are frustrated, and clinicians can’t make informed decisions. When our banks talk to each other seamlessly and online ads show us things we’ve already been shopping for, it is hard to understand why hospitals and doctors’ offices still depend on their fax machines.

A big part of the reason is that interoperability of health information is hard. Though it’s a technological issue, it’s not just a technological issue. As we have seen in other industries, interoperability requires all parties to adopt certain governance and trust principles, and to create business agreements and highly detailed guides for implementing standards. The unique confidentiality issues surrounding health data also require the involvement of lawmakers and regulators. Tackling these issues requires multi-stakeholder coordinated action, and that action will only occur if strong incentives promote it.

Some of the key challenges in implementing EHR Interoperability are as follows:

1. Insufficiencies in interoperability standards : While standards for electronically exchanging information exist, stakeholders said they are not sufficient for achieving full interoperability. Some standard aren’t specific enough and offer variety in how they can be implemented. If different systems are using different versions of standards, the standard itself becomes moot.
2. State privacy rules are varied : Privacy rules vary state to state, which presents an obstacle when trying to exchange medical records across state lines, according to the report. Additionally, when it comes to state laws related to patient consent of information, states are hesitant to exchange data because they lack the assurance that patients have consented to the sharing of data.
3. Accurately matching patient records : Patient matching presents an issue for interoperability because different systems use different demographic information to match individuals to their health records. Doing so may yield inaccurate results, as patients may have the same names, birthdates and ages. Then trying to corroborate identities between systems that use different demographic data is not possible because systems intake different data.
4. Prohibitive costs : System costs and legal fees can deter providers from achieving interoperability. Some EHR systems require multiple customized interfaces to work with other platforms, and providers have to pay the costs associated with building those interfaces.
5. Lack in governance and trust among entities : Establishing trust between entities that are needed to support interoperability was noted as a challenge, largely because agreements and organizational policies don’t always align between parties.

Are patients ready to adapt EHR Interoperability?

While most of the opinions in this debate come from thought leaders, software providers and medical practitioners, it’s important to also get the viewpoint of some of the most important stakeholders in this scenario: patients whose medical records are stored in EHRs. Research indicates that although patients have embraced the concept and implementation of interoperability, there are a few concerns regarding the privacy and security of the data. These fears need to be addressed honestly. They need to be ensured that electronic records are more safer than paper based records where there is a possibility of manual error as well. The healthcare providers need to talk to patients and make them understand the technology which is safeguarding their information and that they would be notified as soon as there is a breach of data.

What are the solutions?

There are a few technological solutions to implement interoperability in EHRs. One of them is cloud-based EHRs. Traditional server-based EHRs were designed with closed architecture. These were build at the time when clinical interoperability were anticipated but not significantly required. To integrate these systems to be able to share data with other systems need costly interfaces and updates. On the other hand, cloud-based EHRs are designed to more easily integrate with other systems, including other EHRs. They are, by definition, Internet-based, making them more flexible. Cloud based architectures are recent enough to have interoperability integrated into the fundamental design of the EHR. Today’s cloud-based EHRs easily connect with other Internet based health IT systems such as ePrescribing, eLabs, and eRadiology. This connectivity is the backbone of the inexpensive, effective cloud-based interoperable EHR.

Although there are a lot of other technological solutions to incorporate EHR interoperability, they are very expensive and hence the medical providers resist in investing in them. One of the cheaper and more effective solution is that provided by PatientMD. It is an app based platform which enables effective maintenance of EHRs with a very minimal investment. Doctors and patients can easily access patient medical records anywhere in the world. Not only can they access patient health records but also facilitate telemedicine with the help of those records. They can easily view what are the current medical conditions and which doctors are treating the same. A patient can record his medication alerts, allergies, surgeries and procedures, vaccinations, lab reports and many more. This app acts as a one stop solution for EHR for both patients and doctors and easily facilitate the interoperability of EHRs.

But to truly eliminate data isolationism, the industry will have to make data sharing a priority and promote more flexible systems over those that are unable to offer true interoperability. More efficient and standard policies will have to be made. Only then will the interoperability be implemented at full extent and both the patients and doctors will be benefitted from the same.