ONC tackles interoperability barriers

By Bernie Monegain
10:57 AM
Progress is being made, but some organizations struggle

Just as it takes two to tango, it takes two to exchange healthcare information, and therein rests the rub.

Many hospitals ready and willing to exchange healthcare data with other providers find themselves stymied because the healthcare organization at the other end is unable to receive it.

It is one of the chief barriers to interoperability, Vaishali Patel, ONC senior advisor, told the federal Health IT Policy Committee at its meeting Tuesday.

"We examined a number of technical, operational and financial barriers to interoperability," she said, "And we found that lack of exchange partners with the capability to electronically receive information, whether that was because they lacked a system or because their system lacked the capability to receive the information was a top barrier to interoperability, reported by about six in 10 hospitals."

[See also: Interoperability: Just ahead or still far off?.]

The numbers Patel reported were derived from a 2014 American Hospital Association survey of providers.

Exchange with outside ambulatory care providers and hospitals has been increasing significantly over time, she noted. About three quarters of hospitals report data electronically and exchange laboratory results, radiology reports, clinical care summaries and medication lists with ambulatory care providers or hospitals outside their organization.

"This has been significantly growing since 2011," she said.

Nearly half of hospitals, about 48 percent, report that their providers engage in electronically finding, or querying, for patients' health information from sources outside their organization or hospital system," Patel said. "Overall approximately one quarter of hospitals reported they conducted all these four types of activities: finding, sending, receiving and using."

Also, a majority of hospitals – about three-quarters of them – are sending summary of care records electronically and about half receive summary of care records electronically, said Patel.

While those numbers are encouraging on the surface, the ability of hospitals to use or integrate summary of care records into their EHRs, without manual entry, lags behind with about four in 10 hospitals able to do that, she pointed out.

[See also: Interoperability done in 10 years?]

Paul Tang, MD, vice president and chief innovation and technology officer, Palo Alto Foundation, and vice chairman of the committee, asked Patel to elaborate on the inability of some organizations to receive electronic information.

"For hospitals, infrastructure is nearly universal, but that's not the case for all providers along the care continuum," Patel responded.

As example, she offered behavioral healthcare providers and long-term care providers. The rate of sending and receiving data between those providers is considerably less than ambulatory care providers and other hospitals, she said.