Last month, Rep. Phil Gingrey, MD (R-Ga.) blasted electronic health record giant Epic during a hearing on technology and healthcare hosted by the Subcommittees on Communications and Technology and Health, saying the platform is not interoperable.
"Congress has spent, as we all know, something like $24 billion over the past six years buying products to facilitate interoperability, only to have the main vendor under the program, Epic, sell closed platforms," he said. "Do you believe the federal government and the taxpayers are getting their money's worth subsidizing products that are supposed to be interoperable, but they're not?"
He referenced a RAND report, which cites a lack of interoperability as a reason EHRs have not yet reached their full potential. The report draws specific attention to Epic, saying the closed platform makes data exchange with Epic difficult and costly.[1]
Epic disagrees. Peter DeVault, director of interoperability at Epic, told Politico Epic providers exchanged 313,000 records with providers using different EHR systems in June 2014 alone. "If you talk to our customers and [see] the ease in which they're able to set up connections with non-Epic sites, you'll find exactly the opposite, that we have a great reputation," he said in the report.
According to a recent KLAS report, both sides may have a point. Interviews with 28 total Epic and non-Epic providers revealed exchanging data between Epic systems and other vendors' EHRs is not easy, but providers have found ways to successfully share patient data. The most commonly cited way to exchange data between the systems was through a regional or statewide health information exchange, or through a health information services vendor. Some were able to achieve direct interoperability between the disparate systems, though the brunt of the effort often fell on the non-Epic customer.
"Epic is seen by many competitors and providers as not playing well with others," said report author Mark Allphin in a KLAS news release. "Yet the providers we interviewed told us a more complex story. Data is being shared, but the effort required to get there can be very different depending on whether you are on the Epic side of the exchange or with some other vendor."
Regardless, Congress is asking the ONC to take action. In comments attached to a recent spending bill, the Senate Appropriations Committee has asked the ONC to investigate the problem and "take steps to decertify products that proactively block the sharing of information." The senators, Democrats and Republicans, say not doing so would both limit the clinical and operational benefits of EHRs and be misusing taxpayer dollars.
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[1] An Epic spokesperson denounced the report, asserting the report's Department of Veterans Affairs authors were attempting to make the VA's system, VistA, look better by comparison, reports Politico.