Interoperability progress, but still 'much to be desired,' says KLAS-CHIME report
A KLAS-CHIME white paper released Tuesday found that the rate of provider organizations achieving "deep interoperability" has doubled since 2017, with roughly two-thirds of provider organizations often or nearly always having access to needed records.
"The overall rate leaves much to be desired, but signs of progress are visible," wrote report authors. The report examined trends in interoperability overall, finding that electronic health record connections with outside systems have improved, that ambulatory clinics and smaller hospitals are connecting more than ever before, and that national networks have reached a tipping point.
At the same time, said report authors, there is still ample room for improvement.
WHY IT MATTERS
Deep interoperability, as defined by the authors, refers to the percent of interviewed organizations that:
- often or nearly always have access to needed data through any interoperable means.
- are able to easily locate specific patient records or have them automatically presented to clinicians.
- have the retrieved patient data fully integrate into the EHR's native data fields or in a separate tab or section within the EHR.
- feel retrieved patient data often or nearly always benefits patient care to the extent that it should.
KLAS and CHIME found that at this point only 15% of customers reported that retrieved data often had, or nearly always had, an impact on patient care.
In terms of EHR connectivity, the research group found that some vendors have taken an active role in supporting data sharing with exchange partners using a different EHR, with others making less progress in that direction but leading the way in API adoption.
Still, about half of surveyed providers said their EHR vendors' high costs and lack of technical readiness was actually making interoperability harder, with the high prices of new interfaces and system customization frequently presenting barriers.
These hurdles were particularly acute for smaller organizations, the report found, although ambulatory clinics and acute-care hospitals are connecting more than ever as a result of EHR vendor consolidation.
Report authors also noted that FHIR APIs have begun to take hold, especially for patient-record exchange, clinician-enabling tools and patient-facing tools in use at larger systems.
The app landscape is still in its early stages, with patient-facing tools the ones most commonly used.
"Several organizations that are not leveraging patient-facing apps or are using homegrown apps indicated they are in the process of certifying with Apple to leverage the Apple HealthKit FHIR functionality," according to the report.
In fact, roughly one-quarter of organizations surveyed said that they're live with FHIR APIs, but that it's too early for them to rate their satisfaction with these connections – often because of a lack of patients' adoption of apps. (Nearly 40% of respondents said they were not attempting to use them at all.)
Going forward, the report found that robust record exchange and population health are among provider organizations' top needs.
THE LARGER TREND
As President Joe Biden's new National Coordinator for Health IT pick. Micky Tripathi, noted in 2014, many technological and cultural factors have challenged interoperability's progress over the last decade.
"Up until now, there hasn't been enough demand for interoperability in healthcare," he said at the time.
That said, technical and legislative changes have spurred innovation, with Tripathi noting four years later that the industry is at a "signature moment in nationwide interoperability."
The compliance dates for ONC's information blocking rules – which themselves are likely to be transformational – are drawing steadily nearer. The agency released a series of guides and toolkits earlier this month to help health IT developers get into gear.
ON THE RECORD
"Since KLAS’ prior large-scale interoperability study in 2017, the market has made notable progress; access to outside records has increased, provider organizations are connecting to more critical exchange partners than ever, and the use of APIs offers new ways to facilitate data exchange in service of myriad use cases," wrote authors of the KLAS-CHIME report.
"Even with all this progress, there is still a significant opportunity for EHR vendors and provider organizations to partner effectively to help data exchange truly impact patient care," they said. "With additional work, the industry appears poised for improvement in this area going forward."