The efficiency of healthcare requires widespread and effective communication among all facets. This includes primary care physicians, specialists (such as allergists, endocrinologists, gynecologists, etc.), laboratories (in case of testing), pharmacies (in order to prescribe medication), and hospitals. Each of these areas requires extensive information about a patient in order for them to properly and successfully perform their functions.
With the Affordable Care Act (ACA) and MU incentives, there has been a rapid transition to electronic health records (EHRs) in recent years. However, each system, though equipped with handling similar tasks, is variably different. This makes it difficult for the systems to connect with one another. Less than 40% of providers are able to share medical information with other providers using their EHR systems. Many are unclear on what the benefits are for enduring the predicament of developing interoperability between EHR systems. It’ll likely be a long and meticulous process. Why, then, must it be done?
Patient care is the single, most important answer. Everything physicians do is for the benefit of their patients. Better correspondence between EHR systems will allow patient care to be considerably more prompt and efficient. Health Information Exchanges (HIEs) can provide exactly that. HIE networks stipulate certain standards for sending and retrieving electronic data. Among the requirements to be eligible for CMS incentives is the ability to convey information electronically.
According to healthit.gov, there are four particular areas of EHR systems that should be addressed when developing an interoperable network:
- The interaction of applications and users: How is the operator using the system? What are the functions in use (i.e. e-prescribing)?
- Inter-system communication: How do systems correspond with one another?
- Processing of information: How is data managed?
- Integration of consumer devices with other systems: How does the system work with mobile devices such as tablets?
Several efforts have been made to help improve interoperability between networks.
- The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) reporting categories include several measures highlighting improvements in patient safety, care coordination, population health management, and more. In fact, interoperability is a key objective of MACRA implementation.
- The possibility of implementing a National Patient Identifier (NPI) has been tossed around for years. An NPI would develop an index of patient records and allow patient identification through a single source. Providers would have access to up-to-date patient information as needed, without having to go through referring physicians and waiting for records to be sent over. However, there are some concerns as to how an NPI could be properly implemented without threatening security and privacy.
- HL7’s Fast Health Interoperability Resources (FHIR) is a proposed interoperability standard that would develop a way for providers to efficiently share health information in various contexts. HL7 CTO, Wayne Kubick, will discuss how FHIR can help improve patient outcomes at HIMSS17.
Keeping this information in mind, physicians and developers alike can deliberate on how best to construct a network that will allow clear and efficient communication among providers. With an interoperable system, crucial data is available instantaneously to those who need it. This data transfer will help to increase productivity and sustain workflow. A uniform configuration for the continuity-of-care documents and records that EHRs produce will also be advantageous in facilitating an interoperable network. Meaningful Use Stage 2 accentuates the need for the exchange of information between providers.
Author: Apoorva Anupindi