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EHR Interoperability Still Proving a Struggle for Providers

Despite recent advancements, 41 percent of surveyed health record administrators report still struggling with EHR data exchange between providers.

EHR Interoperability

Source: Thinkstock.

By Kate Monica

- While EHR technology has made significant strides in the healthcare industry over the past few years, several hurdles to true interoperability still bar providers from seamlessly exchanging data in a way that is timely, efficient, and accessible.

According to a recent Black Book survey, 41 percent of surveyed health administrators face challenges when attempting to exchange electronic health records (EHR) between providers—specifically, providers operating on different EHR platforms.

Further, 25 percent of providers state patient information they receive from external sources is completely inaccessible and unusable when they are able to retrieve it.

However, EHR systems, while occasionally falling short in their capacity to transfer information between independent providers, are fulfilling their role as the structural technological backbone of clinical settings. According to Black Book, 81 percent of network physicians report relying on their core health system EHR technology to allow for interoperability among integrated healthcare delivery providers to enable data-based initiatives including population health, precision medicine, and value-based payment models.

While EHR technology is missing the mark in its ability to transcend disparate systems and transfer information effectively in some cases, the technology is still successful in promoting data exchange within hospitals

"As inpatient organizations implement optimized EHR software that uses FHIR to advance interoperability and HIE, the entire provider network gains the data exchanging functionality to better serve patients," said Doug Brown, Managing Partner of Black Book. "Physician groups continue to lack the financial and technical expertise to adopt complex EHRs which are compulsory to attain higher reimbursements by public and private payers."

Problems with financial and technical expertise primarily affect smaller, independent practices and rural hospitals without the resources of larger institutions. In order to keep pace with larger hospitals, small, rural hospitals require financial backing to improve faulty infrastructure and promote interoperability industry-wide.

Consistent EHR replacement will be a crucial component of bolstering health data exchange across providers.

"Integrated delivery network EHRs are the future's source for trusted provider data integration and leading to the increase in physician EHR replacements in line with the hospital system,” Brown said.

At present, the lack of system compatibility is having noticeable effects, with the Black Book survey reporting 70 percent of hospitals are not using patient information outside their own EHR in Q1 of 2017. The external providers’ data is not available in their EHR systems’ workflow, so this data is simply not available or usable for them.

Transferring data from disparate systems often renders the information illegible or not usable, and consequently 22 percent of medical record administrators report receiving inaccessible information from external sources. 21 percent of hospital-based physicians state the data they view from outside sources cannot be trusted for accuracy if it was sent from an incompatible system.

Revenue cycle management is also an issue for many providers in the early phase of 2017. Claims reimbursement rates are declining while value-based care is meant to remain a top priority.

With the Quality Payment Program going into effect, physicians must assess their readiness to handle the expectations of the initiative. 82% of surveyed independent physician practices have voiced their concern that their groups do not have the necessary connectivity, data analytics, or technology capabilities to handle the financial risk associated with adhering to the Quality Payment Program.

Because of these strains, 63 percent of surveyed independent physicians are considering merging with a larger integrated healthcare organization to better their technological resources and improve reimbursement. 92 percent of surveyed hospital executives stated the financial pressures under the Quality Payment Program will motivate more physician and post-acute care provider acquisitions over the course of the year.

On the bright side, Black Book found EHR replacement activities will increase by 52 percent in 2017 for acquired physician practices.

Over 3,000 hospital EHR users offered feedback on their plans to renew current contracts, purchase additional products and services including HIE, population health tools, and revenue cycle management. They also weighed in on their projections for the likelihood a client will recommend their inpatient EHR/HIT vendor to peer hospitals.

The top vendors based on client experience in 2017 are Evident CPSI for small and rural hospitals under 100 beds, Cerner for Community Hospitals between 101-250 beds as well as hospital chains, systems, and IDNs, and Allscripts for medical centers over 250 beds.

These providers are ranking first in client experience for EHR services, but also for FHIR services as well, paving the way for improved interoperability in the future despite present challenges. 

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