UCSF-led Study Finds Progress Towards Hospital EHR Interoperability is Slow

UCSF-led Study Finds Progress Towards Hospital EHR Interoperability is Slow Researchers say that efforts have focused on ensuring the flow of data between hospitals rather than improving the usability of information in clinical decisions.

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Electronic health record (EHR) documentation tools along with timely and accurate medical transcription services increases both the quality and the utility of clinical documentation.

However, recent research shows that hospitals still have a long way to go in ensuring EHR interoperability. The study, which was published in Health Affairs, notes that efforts have been directed towards ensuring the flow of data between hospitals rather than improving the usability of information in clinical decisions. This is a matter of concern in that achieving “widespread interoperability” by 2018 has been declared a national objective.

Importance of EHR Interoperability The term “interoperability” refers to electronic access to and integration of data from different providers. EHR interoperability is critical for better patient care. Physicians see new patients every day, relying on the important information they get from the history and physical exam, and use the data to make informed medical decisions. Physicians depend largely on the information that the patient provides when taking a history, but the ability to access to subsets of data from prior admissions such as clinical notes, lab tests and other patient information, will allow clinicians to easily get a full picture to make the right treatment decision quickly.

The Office of the National Coordinator for Health Information Technology of the U.S. Department of Health and Human Services points out that EHR Interoperability: -

Improve workflows

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Reduces uncertainty

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Allows data transfer among EHR systems and health care stakeholders

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Makes the right data available at the right time to the right people

To create an interoperable health IT environment, EHR products need to achieve standards in four areas: -

How applications interact with users (such as e-prescribing)

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How systems interface with each other (such as messaging standards)

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How information is processed and managed (such as the exchange of health information)

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How consumer devices integrate with other systems and applications (such as tablets and PCs)

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Findings on US Hospitals’ Interoperability Engagement The new study found that US hospitals are still far from the goal of achieving widespread EHR interoperability. It was based on data for 2014 and 2015 from the IT Supplement of the American Hospital Association Annual Survey and covered 3,538 hospitals. The study examined four domains of interoperability: finding data, sending data, receiving data, and integrating data. The researchers’ key findings are as follows: •

Only about one-fifth of U.S. hospitals were engaged in all four of its primary domains—electronically finding, sending, receiving and integrating information into EHRs.

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In 2015, less than a 30 percent of the nation's hospitals (29.7 percent) had achieved at least some proficiency on measures of “interoperability, a small increase from 24.5 percent in 2014.

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The level of hospital engagement increased in three of the four domains but remained almost stagnant in integration. This is a matter of concern as integration is crucial for data usability.

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In 2015, 43 percent of hospitals reported that they had outside clinical information available electronically when necessary and 19 percent of hospitals reported that they “often" used this clinical information to deliver care.

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29 percent of hospitals said they used outside clinical information “sometimes,” 18 percent reported using it “rarely” and 19 percent “never” used it.

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Of the hospitals that “rarely” or “never” used information received electronically from outside sources, the most commonly cited barrier among 49 percent was the fact that clinicians could not view the information in the EHR as part of their workflow.

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Other barriers included difficulty in integrating information into the EHR, not having the information available when needed, and not having it presented in a useful manner.

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Privately owned and for profit hospitals, specialty hospitals, and those that participated in a patient-centered medical home (but not an ACO) were all more likely to have access to outside information and use it in care delivery.

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EHR Interoperability - Much Room for Progress The researchers noted that though the fact that almost 50 percent of hospitals have outside clinical information available, there is still much room for progress. They noted that having a comprehensive

EHR

system

would

allow

integrating

information

without

manual

intervention. “A key enabler of integration appears to be using the same vendor for EHR and HIE, which avoids the complexity associated with integrating external information received from a third-party intermediary25 and likely explains the growth of EHR-vendor HIE networks, the lead researcher wrote The team also stressed the need for shifting the policy focus from transmitting information between hospitals to ensuring information usability.

Medical transcription outsourcing helps providers avoid loss of documentation integrity which could compromise patient care, care coordination, and quality reporting and research and lead to allegations of fraud and abuse. However, as this new study notes what’s important is shifting hospitals’ focus to EHR interoperability to make this information available at the point of care when it is clinically relevant.

www.medicaltranscriptionservicecompany.com

(800) 670 2809