Interoperability issues keep clinicians from sharing health info electronically

Survey highlights barriers to electronic information exchange for transitions of care
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Clinicians want to share health care information electronically, but are stymied by electronic health records that can't communicate with one another, a lack of information-exchange infrastructure, and the expense of setting up electronic interfaces and information exchanges, a new survey finds.

The survey, "Clinician Perspectives on Electronic Health Information Sharing for Transitions of Care," released today by the Bipartisan Policy Center in Washington, D.C., found that 80 percent of clinicians surveyed said electronic exchange of health information will improve patient care and care coordination. In addition, 69 percent said electronic information exchange would make their practices more efficient, while 57 percent said it was important to reducing health-care costs.

But another clear majority, 71 percent, identified lack of EHR interoperability and exchange infrastructure as major barriers to health information exchange. Nearly as many, 69 percent, identified the cost of creating and maintaining interfaces and exchanges as a major barrier.

In a report based on the survey  findings, the BPC and Doctors Helping Doctors Transform Healthcare noted that the Stage 2 Meaningful Use guidelines have helped to set the stage for electronic health information exchange, including specifying standards for transferring data.

Clinicians also are beginning to agree about the importance of electronic information exchange when patients are transitioning from hospital to other types of care, the report noted. The next caregiver most needs access to a patient's medications, lab and imaging results, the survey found, but clinicians also see discharge summaries, the reason for referrals and a summary of care and recommended changes in treatment as important.

Other findings: More than half of the clinicians surveyed wanted the most critical information "pushed" to them electronically, but wanted to selectively retrieve other data, perhaps after receiving electronic reminders or alerts.

Recommendations from Doctor Helping Doctors included: 

  • Developing a national strategy and long-term plan for standards and interoperability, and aligning competing public- and private-sector efforts.
  • Collaboration among primary-care clinicians, medical specialties and hospitals to define common information-sharing needs promoting coordinated, value-based care.
  • Guidance from the federal government to support both "query" access to priority information and transmission of imaging test results for transitions of care.
  • Creating a national strategy to more accurately match patients with their electronic records.
  • Exploring ways for patients to facilitate accurate records matching.
  • Launching a national forum to share lessons learned and best practices.
  • Establishing an anti-kickback safe harbor and exception for payments associated with electronic data transmission with a referral or order, and for health IT donations.
  • Issuing comprehensive, clear guidance on compliance with federal privacy and security laws.
  • Developing technical standards and guidance to support different models of patient consent.

Other recent research underlines the findings, such as an ECRI Institute survey finding only 54 percent of hospitals and healthcare systems surveyed had formally assessed their health information system interoperability needs. Those gaps could result in "unanticipated impediments to exchanging critical information may arise for essential patient care, quality, or cost information," the report's authors wrote.

To learn more:
- see the survey results
- read the report

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