Beyond the EMR: The interoperability solutions healthcare executives want

Kathleen Aller, director of market strategy at InterSystems' healthcare division, recently accompanied her husband to a pre-op visit at a well-regarded orthopedic clinic. He needed his knee replaced and the clinic wanted to run through an integrated process where the care team and patient met to coordinate the care plan.

This content is sponsored by InterSystems

Ms. Aller said the clinic was an advanced user of a popular EMR — she assumed each member of the care team would have easy access to her husband's medical records. Still, the physical therapist asked him whether he'd had any joint replacement surgeries before; he had, at that clinic, in 2016. The therapist then told him to bring all copies of his X-rays with him to his physical therapy appointments; while his X-rays were completed at that facility, the therapist didn't have access to them online.  

"This is an organization that's invested heavily in IT, and yet they're not getting all the benefits of it, even in an extremely well-coordinated care process. I've lived it, I know it's well-coordinated. And yet it's still highly manual," Ms. Aller said, adding that, the absence of an innovation mindset prohibited the clinic from using its tech to its highest potential.

Ms. Aller's comments came during an event at the Becker's Hospital Review 7th Annual CEO + CFO Roundtable in Chicago Nov. 13. For the session, 22 senior healthcare executives gathered to discuss innovation in the era of the EMR. The session was sponsored by InterSystems, a software and IT vendor that supports healthcare systems, business and government entities.

A 'multi-health' world requires advances in IT

Don Woodlock, vice president of InterSystems' HealthShare informatics platforms, put it best: Providers are operating in a multi-health world, which he described as "generally dealing with multiple organizations, multiple caregivers trying to take care of a patient, multiple patients, as you take on a risk."

This means now, more than ever, IT systems need to be able to share health information. To stay afloat, healthcare organizations must innovate beyond the EMR.

Mr. Woodlock asked attendees to share a project they are trying to accomplish that requires IT. Here's what four executives had to say:

1. A chief marketing officer at a behavioral health organization in the West said he wants IT to improve the patient journey across the continuum of care.

2. The president of the board of commissioners for a public hospital in the West said she'd like to see the EMR revamped to provide a longitudinal view of the patient, especially as her hospital sees an influx of elderly patients who have difficulties navigating the complex, disparate healthcare system.

3. The CEO of a community-based hospital in the Midwest said he'd like to see EMRs augment physicians, not slow them down and negatively affect their job satisfaction.

4. The COO of a rehabilitation center in the East that recently went live on a new EMR said a lack of access to high speed internet is an issue her organization is forced to work around, especially as it works to connect with patients outside the hospital walls.

Many of the healthcare executives said their organizations wanted to avoid issues with interoperability and selected IT systems already used by other local organizations. This was especially true for smaller or rural hospitals that compete with larger entities in their regions, said the COO of a county hospital in the South.

According to the executive, this trend hinders provider satisfaction by taking away some of their decision-making power. That's because these organizations feel pressured to be on the same systems as other organizations in their region — rather than select a system that meets their unique needs — so they can exchange patient data with one another, she explained.

"So, it would help you if you could have that shared view of the world, but not be required to adopt their worldview," Ms. Aller confirmed.

The interoperability solutions health executives want

Mr. Woodlock asked the executives what IT solutions they'd like to see. Here are five solutions called for by executives:

1. The same COO of the hospital in the South said she'd like to see a solution that sits on top of all her organizations' preexisting technologies to grab data and bring it into a common platform. The COO of a hospital in the Midwest said it would be helpful if such a tool could also facilitate data sharing beyond providers and exchange information with drug stores and pharmacists. In this way, he wants to see the EHR function as a common source of truth. By this, he means "no matter where [a patient] goes, someone should be able to get a pretty big picture of that person's health."

2. The COO from the Midwest also said a secure messaging tool — one that is truly secure — would also be helpful. "Something that would be nice, as we become more and more digital, [would be] the ability for somebody to do true secure messaging that gets the input to an EHR to capture all [disparate] information that [comes through] 5 or 10 seconds at a time," he said.

3. The CEO of an ACO in the East would like a solution for claims data analytics, but in a way that would isolate the data from the EMR. Similarly, other leaders — such as the CFO of a health center in the Pacific — would like an easier way to get billing data into CFOs' hands. Right now, it is a very manual process that a technology could likely facilitate.  

4. The president of the board of commissioners at a public hospital in the West would like to see a solution to mobility, or a fix so that patients aren't forced to carry paper copies of their charts from provider to provider.

5. Leaders also expressed desire for a solution to better protect the privacy and security of health information during information exchanges between organizations. The COO of a county hospital in the South said providers often don't take the necessary steps to encrypt the data and decrypting data can involve a burdensome number of steps.

Don't forget the patient

Regardless of which solution healthcare organizations deploy, the leaders agreed that enhancing the patient experience and ensuring optimal patient care should be top of mind. This means ensuring patient information — however it is sent — is secure and gets to the right provider's hands at the right time.  

Many executives said their organization experienced challenges when exchanging health information during transitions of care, such as discharges to a skilled nursing facility. One executive — the CEO of a hospital in the West — explained his organization devised a complex workaround in which it temporarily assigns patients to an empty hospital bed so their information flows where the clinicians need it to be. Although the patients' level of care never changes, and they don't physically move beds, this workaround is inefficient.

The interoperability solution the executives want must be convenient, efficient and secure. It should also provide patients with easy access to their own data, and access to that data in a format they can understand.

A solution designed in this way, the executives agreed, would value the patient first while also making it easy for care teams.

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