Our industry is swirling with health data exchange initiatives to enable better population health management. Everyone understands that an open, collaborative approach will help us achieve the promise of interoperability.
But to shape successful efforts, it’s important to take a step back and look at available research on interoperability. What does the evidence tell us about factors that will lead to population health success?
The Office of the National Coordinator for Health Information Technology (ONC) offers many helpful resources. Two ONC data briefs* offer compelling facts and figures that should shape our interoperability efforts, including the following research about U.S. hospitals:
1) 46% of hospitals have access to electronic patient data, from sources outside their clinical systems, at the point of care
This is the national average in 2015, which is up from 41% in 2014. This research also shows that the average is much higher (89%) among hospitals performing in all four core domains of interoperability, defined as electronically sending, receiving, finding and using key clinical information.
Response: I think progress is encouraging, but it’s not enough. Notice what the findings tell us about hospitals that are successful across all the aspects of interoperability. We must seek solutions that enable not just one or two but all four capabilities.
2) Fewer small, rural and Critical Access Hospitals (CAH) had electronic patient data from other sources available at the point of care
While the national average was 46%, small hospitals averaged 39%, while rural and CAH organizations averaged 35%.
Response: Because one in five Americans lives in a rural community, we cannot underestimate the importance of interoperability for CAHs. I am encouraged by organizations such as North County Hospital (Newport, Vermont, U.S.A.), that are leading the way in this category, by finding a way to communicate, integrate and exchange data with other systems, without having to rip old systems out.
3) 53% of hospital clinicians who receive electronic patient data from other sources use it when treating patients
This means that information from outside sources offers clinicians a more complete view more than half the time.
Response: At Allscripts, we believe clinicians should have access to normalized, harmonized information every time. Our CEO shared an example from UPMC: After enabling them to access a community-wide view of patient data, UPMC physicians made a different clinical decision 60% of the time. Information is powerful in the hands of clinicians and interoperability enhances opportunities to make the right decisions for patients.
4) For clinicians who do not use this data, the number one reason is because the information does not appear within the electronic health record (EHR) workflow
53% of hospitals that rarely or never use electronic patient data from other sources say that the reason is the information does not appear within the clinician’s workflow. The second most common reason? It’s too difficult to integrate it into the EHR.
Response: This capability is a critical component for success of any interoperability solution, and one that we offer through our interoperability engine, Allscripts dbMotion Solution™, a key component of our CareInMotion population health management platform. Yes, some solutions can send and receive information, but is it integrated and accessible from the EHR workflow? Is it actionable information? These are the aspects that will make or break interoperability’s success.
5) About half of hospitals reported challenges exchanging data across different vendor platforms
Other significant technical barriers include the lack of capability among EHR systems to receive data.
Response: With the rise of collaborative industry efforts, I think days are numbered for vendors who are “closed” and make it difficult for third parties to connect with their software. Interoperability platforms should be EHR agnostic, enabling full connectivity among healthcare organizations.
Interoperability solutions must overcome these remaining challenges. As an industry, we too often settle for interoperability in its most basic forms, such as systems that require you to log in and search for information summarized in pdf format. That isn’t true interoperability; we need to expect more from standards and solution capabilities. The success of every population health management initiative depends on it.
* ONC Data Brief 36: Interoperability among U.S. Non-federal Acute Care Hospitals in 2015 [PDF – 1.2 MB] and ONC Data Brief 37: Variation in Interoperability among U.S. Non-federal Acute Care Hospitals in 2015 [PDF – 1.6 MB]