As we’ve seen before in regards to electronic health records, interoperability is a hot topic in health care today. Greater sharing of and transparency around data holds huge promise for reducing system efficiencies, providing better coordinated care to patients, and reducing administrative and service-related costs. Despite these potential benefits, system-wide interoperability is not going to be an easy thing to implement. A recent article from the online health news site Managed Health Care Executive identifies five major barriers that are impeding the smooth flow and sharing of data in the health care sphere.
The diversity of electronic health records (EHRs) and EHR interfaces
Now in widespread use across the country, EHRs may be required to meet certain efficiency standards outlined by the government, but there is remarkably little standardization beyond that. In order to make EHRs functional and user-friendly for their own particular workplaces, different health care systems may make hundreds of customizations to their EHR systems. The resulting variety of EHR interfaces makes the sharing of information between systems a highly complex process. A survey conducted in 2014 by the American Hospital Association found that issues with sending, receiving, or finding patient health information electronically were all too common: 63% of the hospitals surveyed reported that they were frustrated in their efforts to share health data because the intended recipient did not have an EHR or similar system with the ability to receive the data. Similarly, 60% of survey respondents reported that even when other providers did have an EHR system, they were still not able to receive electronic information. And sometimes the problems are even more basic: surprisingly, nearly half of all survey respondents (46%) stated that it was difficult to find the electronic address of the providers they were attempting to reach.
An ever-growing number of data sources
As wearable health technology becomes more sophisticated and the devices themselves grow increasingly popular, the volume of patient-generated health data is increasing at a rapid rate. Sales of fitness, activity, and sport trackers are estimated to reach 60 million in 2016 and 187 million by 2020. That’s a huge amount of data that providers could potentially make use of to improve their care delivery, particularly for patients who are elderly, living with chronic conditions, participating in wellness programs, or who are based in remote areas without easy access to health professionals. However, data is only useful if you have the necessary technology to store, sift, analyze, and share it. At present, the capacity of most health system interfaces is simply not adequate to the task.
New and more complex partnerships
Partnerships between larger systems such as hospitals and smaller practices such as ASCs are becoming increasingly common, but they can pose a huge challenge when it comes to getting all the IT systems involved to work together. Integrating records of a smaller practice with those of a larger facility can involve dealing with multiple systems, including scheduling, call center management, and even paper record keeping, and the time and budget required to manage this transition properly isn’t always fully understood ahead of time by the partners involved. To avoid surprises in this area, data experts recommend that acquiring partners conduct a thorough audit of the IT system of a potential acquisition by a taskforce including system users and IT staff, and work to develop a road map to interoperability before making final buying decisions.
Difficulty in managing payor participation
Despite the fact that payors typically have a wealth of patient information that could greatly benefit providers in developing comprehensive care plans, they have so far proved reluctant to collaborate on interoperable systems. Until very recently, according to a survey conducted earlier this year by Black Book Research, the perception of data sharing was that it mainly benefitted providers, leaving little reason for payors to contribute. Add to this the distrust reported by 60% of providers for payor-guided health information exchange (HIE) initiatives, and it’s clear that the issue of interoperability and data sharing is a contentious one for payors and providers. However, as value-based care models rise in prominence, greater collaboration between these two parties will be essential in order to ensure effective care delivery.
Work flow issues
Interoperability isn’t just about data. Work flow is an equally important component, but one that tends to be overlooked in efforts to move toward interoperability. Medical informatics experts often find that health care systems blame their lack of progress on data-related problems when, in fact, it’s often due to insufficient attention to what’s happening in the area of work flow. Data is only useful and actionable if the work flow related to its input and exchange is running smoothly, so ensuring that work flows, as well as data, are efficiently integrated between health care organizations is a critical step on the path to interoperability that must not be missed.