Electronic Health Records

Integration & Interoperability News

Are EHR Vendors Culpable for Lacking HIE, Interoperability?

A Black Book survey takes a look at different provider and payer opinions on HIE and interoperability.

By Sara Heath

- A total of 57 percent of healthcare professionals blame slow interoperability uptake on EHR vendors and health data blocking, according to a recent Black Book survey. Another 20 percent blame it on insufficient interoperability monitoring efforts on the part of government health agencies.


The survey, which questioned over 2,000 provider HIE users and 2,300 payer HIE users, found that vast majority of healthcare providers and hospitals are still playing catch-up when it comes to interoperability.

As stated above, most of these providers blame EHR vendors, data blocking, and government healthcare agencies for their slow adoption. Only 17 percent identify themselves as the primary inhibitor of their interoperability growth.

“The misalignment of requirements and protocols has hampered all the stakeholders’ interoperability efforts,” said Black Book’s managing partner Doug Brown. “This disorder is ushering in a new replacement revolution, this time for those HIEs failing to meet the expectations of their users, payers and providers alike.”

Because of these lacking HIE and interoperability standards, several healthcare providers and organizations reported plans to abandon their current HIE – whether it be public, private, or EHR vendor-supplied – and participate in a new one.

Ninety-four percent of respondents reported plans to help create or bolster a private intrastate HIE that fits their organization’s needs better than the HIE in which they already participate.

Specifically, healthcare organizations look for HIEs to help them participate in value-based payment models. Because these payment models require robust care coordination and adequate health data sharing with patients, it is imperative that they have the correct interoperability abilities to be successful.

“The value-based payment reform concept enabled by a robust HIE requires all stakeholders including physicians, insurers, post-acute care, and diagnostic facilities, not just hospitals to reach the goals of dynamic population health,” Brown explained. “Focused, private HIEs also mitigate the absence of a reliable Master Patient Index and the continued lack of trust in the accuracy of current records exchange.”

Health payers are also looking to increase their participation with HIEs. Although previously payers were not seen by providers as partners in health information exchange and interoperability, payers are now boosting their efforts for better HIE.

In the first quarter of 2016, 88 percent of hospitals and 95 percent of payers said they envision an HIE and interoperability movement where all parties involved hold an equal share in development.

Providers are increasingly considering a deal in which they work with payers for HIE, with 93 percent of providers reporting that they may work in a cooperative HIE to help them obtain much-needed health data.

Healthcare providers believe that the healthcare industry is moving in the right direction with regard to HIE and interoperability.

Although over 85 percent of hospital leaders, providers, and payers all believe that the Office of the National Coordinator for Health Information Technology (ONC) has not done enough to prohibit limited interoperability and data blocking from EHR vendors, they most believe that this issue will be mitigated in the future.

By 2015, 91 percent of payers and 74 percent of providers believed a national HIE was likely to come by 2020, provided public and private stakeholders work together to help make it happen. However, this won’t necessarily be due to a vendor pledge, like the one signed at HIMSS 2016.

The burgeoning healthcare data analytics market will help push interoperability innovation, payers and providers believe. Likewise, initiatives like FHIR will help EHRs connect regardless of private investment in interoperability.

“Progressive FHIR standards can allow EHRs to talk to other EHRs should standard definitions develop on enough actionable data points as we are enter a hectic period of HIE replacements, centering on the capabilities of open network alliances, mobile EHR, middleware and population health analytics as possible answers to standard HIE,” Brown concluded.