Johns Hopkins' Pronovost makes the interoperability case

Credit: Getty/Olivier Le Moal

One Johns Hopkins doctor says he knows how to rein in the costs of healthcare: Fix the mess of poorly integrated technologies that drag down workflow, hamper productivity and pull clinicians away from giving patients high-quality care.

The vast array of healthcare technologies might be awe-inspiring, Peter Pronovost, M.D., Ph.D., an anesthesiologist, critical care physician and Johns Hopkins Medicine’s senior vice president for patient safety and quality, writes in a blog post for The Wall Street Journal. But the fact that they don’t talk to each other has serious repercussions.

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“For example, nurses scribble down a physician’s instructions for a drug infusion from one computer screen, do math to find the right dose and then walk to the medication pump and enter the order,” writes Pronovost. And for high-risk medications, a second nurse must double-check that the pump is programmed accurately.

The cost? Johns Hopkins determined that, on a 12-bed intensive care unit, these double-checks add up to two full-time nursing positions, he writes. In the post, Provnost outlines a number of ways that interoperable systems could improve care.

But when will the industry solve the interoperability problem?

“We have not solved interoperability,” Intermountain Healthcare CIO Marc Probst said at an event last month. “We’re not even close.”

In fact, most providers still can’t get patient information from other providers--let alone use it effectively to improve care, according to a recent KLAS Research report. Respondents said they could reasonably access information from exchange partners on a different electronic health record 28 percent of the time.


  • 13 percent found those exchanged records easy to locate.
  • 8 percent said data received and located was integrated into a clinician’s workflow.
  • 6 percent found that the patient data exchanged facilitated improvement of patient care.

The problems were experienced across all facility types and with all vendors.