Less than one-third of hospitals are fully interoperable and even fewer use outside data

Doctor typing on laptop
Interoperability has not kept pace with EHR integration, highlighting a divide that federal officials see as a policy priority.

Less than 30% of health system EHRs are fully interoperable, and less than 20% actually use data transferred from another provider, according to a new study.

The research, published in Health Affairs on Monday, quantifies what many throughout the industry—including federal officials—have highlighted as a priority for EHRs moving forward.

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Using data from the 2014 and 2015 American Hospital Association’s annual survey, researchers at Harvard, the University of California San Francisco and a senior advisor at the Office of the National Coordinator for Health IT found health systems have improved slightly when it comes to searching, sending, receiving and integrating patient data. In 2014, 24.5% of hospitals engaged in all four domains. In 2015, that percentage grew to 29.7%, far slower than the average rate of EHR adoption over the past several years.

But 37.2% of hospitals said they “rarely” or “never” use outside data for patient care. Just 18.7% said they used outside data “often.”

“What this means is there is potentially a significant amount of waste and inefficiency in hospitals,” lead study author Jay Holmgren, a doctoral student at Harvard Business School, told Reuters.

Privately owned hospitals that are part of a larger system and had a comprehensive EHR were more likely to have information from outside sources available to them. Hospitals with a comprehensive EHR, as opposed to a basic system, were more likely to integrate patient information, which the authors highlight as a “critical for information usability.”

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That issue of usability is a central focus for John Flemming, M.D., ONC’s deputy assistant secretary for health technology reform. In a Health IT Buzz blog post, Flemming highlighted EHR dissatisfaction among physicians, and said ONC is working with industry stakeholders as well as the Centers for Medicare and Medicaid Services and Congress to “determine the perfect recipe of usable health IT.”

Interoperability and usability are also the subject of ONC’s National Health IT Week event on Tuesday morning.

The researchers noted that current policy efforts have “stimulated interoperability engagement only modestly” and new measures should hold EHR vendors accountable for information blocking. They also urged hospitals to “demand better interoperability” during discussions about bundled payments.

A greater policy focus on integration, rather than on the sending and receiving of data, may help shift hospitals’ focus to making data available at the point of care when it is clinically relevant,” the authors wrote. “Hospitals should also assess important ‘last mile’ issues, such as when and where outside data are being used.”