AHA, FAH urge faster progress on interoperability in new report

EHR data sharing
All the necessary technology is available to make complete interoperability a possibility, the report argued. The barriers are regulatory and administrative. (Getty/andrei_r)

Seven leading hospital organizations are putting out a call to arms to advance data sharing and interoperability across the healthcare industry.

Data sharing improves care coordination, patient safety, family empowerment, efficiency and cost, the groups wrote in the new report (PDF) released by the American Hospital Association (AHA) and the Federation of American Hospitals (FAH), among others. While health systems have come far with their EHRs in the last decade, those systems are still riddled with barriers to interoperability.

“We see interoperability in action all around us. Mobile phones can call each other regardless of make, model, or operating system," said AHA President and CEO Rick Pollack in a statement. "The hospital field has made good headway, but it’s time to complete the job. We are united in calling for a truly interoperable system that allows all providers and patients to benefit from shared health records and data, leading to fully informed care decisions."

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While 88% of hospitals are now able to send records to ambulatory care providers outside their system, the quality of the receiving systems varies tremendously. Many providers lack the technology to receive records electronically, for instance, or they have a system that is incompatible with those of hospitals. In a 2017 AHA survey, 57% of respondents had experienced challenges sending the proper information to a different vendor platform. And 37% ran into challenges just matching patient identities between systems.

In short, even when hospitals are theoretically set up to electronically share healthcare information, their systems are uneven, inconsistent and speak different languages. So far, interoperability solutions have come through workarounds and patches that are unsustainable, according to the report.

"These solutions often are budget-busting, ineffective workarounds that can compromise patient care. They require expensive technical patches that may connect a few systems but lack general applicability. Such limited fixes require a disproportionate amount of staff time to use and manage—time that comes at the expense of patient care. And, current approaches can lead to clinicians receiving too much, and sometimes duplicate information, presented without tools to find the data relevant to a care decision," the report said.

A more organic approach to data sharing would be to adopt nonproprietary application programming interfaces (APIs), the report added. APIs are the back end of applications that contain all the data and information but none of the user interface. Shared APIs allow applications to pull data from other applications instantly and without changing apps. (Think about the way Amazon.com pulls package tracking information from UPS' and USPS' websites, for example.)

RELATED: Pew calls on ONC to include unstructured EHR data in APIs

If EHR vendors adopted shared APIs, it would be easier to connect relevant information between systems without needing a patch for each one. Such APIs are becoming available—though the standards authorizing them are relatively new.

"There is an urgent need to coalesce around improved standards that overcome the significant gaps making communication difficult between systems," the report said. "For example, APIs, including those based on the FHIR standard, allow for more nimble approaches to accessing needed data."

In addition to AHA, the report was developed with collaboration from America's Essential Hospitals, the Association of American Medical Colleges, the Catholic Health Association, the Children's Hospital Association, the Federation of American Hospitals and the National Association for Behavioral Healthcare.

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