Intermountain's Marc Probst: We're not close to solving interoperability

Marc Probst

Interoperability and reimbursement for telehealth were among several persisting healthcare IT challenges discussed by hospital CIOs and others who gathered Tuesday on Capitol Hill for an event hosted by the College of Healthcare Information Management Executives.

In talking about the former issue, Intermountain Healthcare CIO Marc Probst said that despite the fact that some progress has been made with help from the Office of the National Coordinator for Health IT, there is still a long way to go for the industry to be truly and semantically interoperable.

“We have not solved interoperability,” said Probst, who also is the current board chair for CHIME. “We’re not even close.”

Cara Babachicos, CIO for community and non-acute entities at Boston’s Partners HealthCare and Albert Oriol, CIO at Rady Children’s Hospital & Health Center in San Diego, both agreed. Babachicos said that despite having a standard electronic health record system across all of Partners’ hospitals, a lot of work is still necessary to ensure information is exchanged quickly and accurately between facilities.

“Behind the scenes, there’s a bunch of little mice on wheels that are taking the data from one system, manipulating it and sending it to another system,” Babachicos said. “That’s a full-time job for a team, running these interfaces. ... And once [the data] leaves the organization, all bets are off.”

Oriol noted that his organization in the last quarter exchanged about 500,000 records, but said it failed to connect roughly 150,000 of those because it couldn’t match the identities of its patients.

“Have we solved [interoperability]? I don’t think so,” he said.

Talking about telehealth, Cyndi Cahill, a consultant with Pursuit Healthcare Advisors who previously worked in high-level positions with Siemens and Leidos, said that from her perspective in the vendor community, the adoption rates of such technology historically have been really low or nonexistent because of the theory that hospital CFOs want to see “butts in the bed.” As more pieces of telehealth become reimbursable, that trend is slowly changing, she said.

“It’s getting a little bit better but it’s got a long way to go,” Cahill said.

Oriol added that Medicaid reimbursement in California for telehealth is dependent on patients being in another medical facility, meaning there are no incentives to push for such treatments at home.