15 criticisms on the lack of EHR interoperability from an AHA report

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Are solutions such as health information exchanges and federal standards the answer to achieving meaningful interoperability in the long term, or are they just makeshift fixes? According to a new American Hospital Association report, the answer may unfortunately be the latter.

Here are 15 criticisms on the current lack of EHR interoperability from the AHA's "Why Interoperability Matters" report.

  • Only about 25 percent of hospitals are able to find, send, receive and use electronic information due to significant sharing barriers.
  • Only 40 percent of hospitals are able to wirelessly integrate data into their EHR without manual entry.
  • Health IT tools are essential for building an interoperable healthcare industry, but the tools are expensive, unwieldy and do not yet support easy information sharing.
  • On a day-to-day basis this lack of interoperability reveals itself as incorrect lab values appear in the wrong section of a patient record; as fields in a critical care summary are missing when a nurse or physicians needs them; as text manually entered becomes garbled and illegible; and as providers are unable to share basic details about patients' care.
  • Proper care coordination cannot take place until providers across the continuum are able to communicate accurate data.
  • Lack of interoperability is almost universally seen as a major obstacle to effectively using and meeting the potential of health IT.
  • A critical factor in engaging patients is empowering them with meaningful information about their own health, but most patients still cannot gain access to their electronic information, according to an AHRQ study.
  • More than one-third of patients report an increased burden from their provider due to lack of meaningful information exchange, including having to redo a test or procedure because earlier information was unavailable and having to provide medical history due to EHR complications.
  • Public health reporting, which is critical to the overall health of the public, is also impeded by the lack of interoperability.
  • While interfaces — software programs that enable hospitals to import or export data — are a usable option in some instances, they are costly and a single hospital's fully integrated EHR may require hundreds of separate interfaces for different uses.
  • HIEs have also shown promise for providing a meaningful way for clinicians to securely access patient data between organizations, but providers report they carry a burdensome financial cost. Additionally, many are created as a workaround and not with the larger goal of seamless, national information exchange.
  • In the health IT sphere, some standards are so loosely defined and interpreted that they wind up becoming interoperability barriers, rather than enablers. This is because providers do not collect data in uniform ways and clinicians don't use the same terminologies when they input and classify data.
  • Hospitals have tried to overcome interoperability barriers by using interfaces and HIEs, but there are at best costly workarounds and at worst mechanisms that will never enable true interoperability.
  • The implementation of standards can be part of the solution, but they are not yet specific enough to truly influence change.
  • Until the federal government takes true steps to support interoperability, patients will be shortchanged.

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