AHA: 'Much work remains' for provider interoperability

While hospitals are sharing more data than ever, thanks to increased adoption of electronic health records, limitations and high costs are barriers in their use to improve care, according to a report from the American Hospital Association.

"Hospitals have tried to overcome interoperability barriers through the use of interfaces and HIEs [health information exchanges], but they are, at best, costly workarounds and, at worst, mechanisms that will never get the coun­try to true interoperability. While standards are part of the solution, they are still not specified enough to make them truly work. Clearly, much work remains," the authors of the report write.

Currently, most hospitals can send and receive data through an EHR, a Web portal, or HIE, but only 40 percent of hospitals can use the information without the need for manual data entry into the EHR. In addition, only 23 percent can find, send, receive and use electronic information due to substantial barriers, the report states.

The report's authors say there needs to be interoperability of care coordination, patient engagement and improved reporting for public health, quality and safety data.

Among the issues it points out is the expense of interfaces that hospitals use to connect disparate systems, such as lab, pharmacy and imaging. A single hospital with a fully integrated EHR might have dozens, while a large health system with multiple sites might have hundreds or thousands.

For example, Truman Medical Centers in Kan­sas City, Missouri, has more than 55 connections to external organizations. Truman estimates the average cost of an interface is $10,000 to $20,000, yet that doesn't include the cost of IT staff to implement and maintain these systems. 

The report raises policy questions about the role of federal government, healthcare stakeholders and vendors in creating workable standards to improve interoperability.

The updated federal HIT certification criteria, released Tuesday, focuses more on interoperability throughout the "care continuum," not just on the Meaningful Use program.

The Office of the National Coordinator for Health IT also published the final version of its interoperability roadmap this week.

And two senators introduced a bill that would make interoperability central to a HIT rating system to help customers make better buying decisions.

To learn more:
- here's the report (.pdf)