Providers, Vendors Trending Upwards in Achieving Interoperability

The number of providers that are achieving deep interoperability has doubled since 2017, according to research conducted by KLAS Research and College of Healthcare Information Management Executives (CHIME).

Sixty-seven percent of providers reported they often or nearly always have electronic access to patient medical records and this progress towards interoperability continues to climb. Survey respondents also reported EHR usability and functionality improvements, such as locating and viewing records.

Many respondents expressed optimism that these improvements would boost patient data exchange and result in enhanced patient care.

KLAS said it measures interoperability in four stages. “Deep interoperability” occurs when providers can:

• Consistently access outside patient data
• Easily locate patient records
• View outside data within the EHR workflow
• Experience positive impacts on patient care

“For digital health to reach its full potential, we need to be able to safely and securely exchange information across the healthcare ecosystem,” CHIME president and CEO Russell P. Branzell, said in a statement.

“Interoperability is the linchpin. With the Cures Act and other federal initiatives promoting data sharing, we should see even more gains that ultimately will improve patient care. As is evident in the survey results, great strides have been made resulting in remarkable improvements. This required hard work for all parties involved and they should be congratulated on their collective efforts,” Branzell continued.

From renaming the “EHR Incentive Programs” to “Promoting Interoperability” and the introduction of the interoperability rule, federal agencies are aiming to remove barriers and increase interoperability throughout the industry.

Respondents from ambulatory clinics and smaller acute care hospitals reported increasing their connections with affiliate hospitals’ EHR systems. While KLAS said EHR vendor consolidation has increased over the past several years, thus boosting interoperability across the same vendor, this consolidation increases the need for connections with critical exchange partners.

“This is because as the acute care market consolidates, same vendor exchange is on the rise, and the comparative ease of same-vendor exchange has increased market expectations around broader EMR interoperability,” KLAS explained. “Organizations that previously were under little pressure to exchange with affiliates are now making strides to deepen connections and integration.”

Acute care hospitals with less than 200 beds have shown the most notable increases, according to the respondents. Furthermore, respondents from hospitals with less than 200 beds are asked to exchange data with larger organizations that leverage large EHR vendors.

Survey respondents were almost evenly split over the amount of support they received from EHR vendors and how much support impacted interoperability. Respondents noted EHR optimization costs, such as customizations and functionality improvements, as their top EHR vendor complaints.

When ranking valuable interoperability methods, 39 percent of respondents said public health information exchanges (HIEs) were the most valuable, followed by national networks, direct messaging, private HIEs, point-to-point interfaces, and application programming interfaces (APIs).

“Use of national networks has continued to grow since 2017, when this method was barely on organizations’ radar,” explained KLAS. “Today, perceived value and adoption are higher than ever before, and organizations leveraging these networks are significantly more likely to report achieving deep interoperability.”

Respondents said patient-facing apps are the most commonly utilized apps. Apple is the most common third party being leveraged for patient-facing apps. While some providers said they are leveraging apps from their vendor, some are also using homegrown apps.

Looking forward, respondents said patient data exchange and population health are two of the most important use cases that vendors should focus on over the next two to three years.

“[Our vendor] needs to pay the most attention to sharing records,” said an anonymous chief information officer respondent. “I would like to have the ability to drill down into a record and send specific data instead of having to send a whole record.”

Many respondents also reported social determinants of health (SDOH) data integration as another vendor focus over the next few years.

“While there’s always room for improvement, we were glad to see provider organizations report progress in data sharing across disparate EMRs,” said Adam Gale, president of KLAS. “Many EMR vendors have partnered with customers to push interoperability forward. Some have made a strategic decision to focus their efforts on specific aspects of interoperability, such as FHIR (Fast Healthcare Interoperability Resources). Now we must continue to expand that interoperability beyond the EHR and ensure we truly impact the care of patients.”