Lack of EHR Interoperability a Barrier to Innovation, Quality Care

As a first time visitor to the Healthcare Information and Management Systems Society (HIMSS) conference in New Orleans in early March, I was in awe over the quantity and quality of technology on display. It was obvious that many new innovations and processes would have positive effects on the delivery of healthcare. There were also constant reminders everywhere that our current healthcare information technology is seriously flawed by the lack of interoperability and integration. My excitement over new software processes being introduced was soon tempered by the realization that these new products would not "integrate" with my current EHR.

There are standard definitions to understand the difference between integration and interoperability. Integration relates to how systems can work or collaborate for a common purpose, e.g. a patient management system working with a scheduling system. Interoperability speaks to how these systems are connected, in order to provide a continuous flow of information that improves care for the patient. From a practical standpoint, what this means is that all systems must be integrated in order to achieve interoperability, i.e. a provider's patient management system must be able to authenticate and securely connect to a new software solution that improves healthcare delivery and then be capable of sharing that information with other systems.

The truth is very few EHR vendors are open to integration/interoperability. A competitive marketplace and proprietary software has made it difficult to incorporate new and improved solutions into current systems. For example, a software solution that automates a health risk assessment to trigger clinical algorithms would require input of information into the new solution and the current EHR. Double input could be avoided and patient care and efficiency improved if the vendors created a cooperative environment for integration.

To my surprise there was a leading EHR vendor at HIMSS promoting this cooperative environment. All vendors should use this example. Complete cooperation between vendor and multiple innovative software solution smaller companies has enabled users of that EHR to have the ability to use these solutions and improve the quality of healthcare delivery. The large EHR vendor will have a menu of out-sourced innovative solutions available for their users.

Either as a new purchaser of an EHR or a "re-purchaser," consider the advantages of a system willing to integrate with new and innovative solutions to improve healthcare efficiency and quality. A relevant analogy is to compare the "integrated" EHR vendor to a one-year car lease. Every year you have the choice of new upgrades which improve performance.

I expect next year at HIMSS we will see more of this cooperative effort.