While healthcare has made great strides in recent years with the proliferation of electronic health records, the establishment of regional health information exchanges and the development of data exchange standards and interfaces, interoperability among healthcare technologies remains very limited.
A new publication from the National Academy of Medicine said the lack of interoperability results in waste, inefficiency and clinician burnout, which can contribute to patient safety risk.
Digital interoperability across clinicians, care units, facilities and systems has become more essential because of increasing complexity in healthcare, the need for more seamless interfaces among clinicians, patients and families, and the growing number of clinicians across disparate specialties that are seen by patients.
The authors, who are reported experts in health information technology, clinical operations and healthcare delivery, advocate for health systems to establish comprehensive, ongoing procurement strategies with system-wide interoperability. Hospitals and physician groups need to move away from serial purchases of individual software and hardware with proprietary interfaces, and toward those that will interoperate with others through a vendor-neutral open platform, they said.
As of 2016, 96 percent of hospitals and 78 percent of physicians' offices were using EHRs, the publication said. But due to the lack of interoperability, information from multiple sources across the care continuum were unable to flow at the right time, or to even the right person.
As an example, fewer than one in three hospitals are able to electronically find, send, receive and integrate patient information from another provider. That leaves most providers relying on paper or fax when sending a care summary for patient discharges or referrals.
Unlike other industries where computerization has made work easier, the deployment of EHRs in their current state -- coupled with growing requirements for reporting and regulatory compliance -- creates additional work and exacerbates clinician burnout, the publication said.
The current picture is rife with data silos, hoarding and blocking. Hospitals and other providers purchase systems and equipment from a variety of different manufacturers, and frequently, each comes with its own proprietary interface technology. As a result, most providers spend time and money setting up each technology in a different way, instead of being able to rely on a consistent means of connectivity.
Providers also purchase technology that will work for their system, without considering the systems that interact with their own, or the systems their patients are connected with. These technologies often cannot transfer data to one another, resulting in the need for patients and clinicians to expend energy collecting and collating multiple sets of data.
Although the proportion of patient harm that is directly attributable to the lack of interoperability is unknown, several common causes of medical errors -- including drug errors, diagnostic errors, and failure to prevent injury -- can partially be addressed by better data exchange among patients, medical devices, EHRs, and other health technologies.
Interoperability also has the potential to mitigate the physician burnout issue, which can be exacerbated by disparate EHR systems. Plus, many physicians are no longer limited to just one facility. Many handle rounds at multiple hospitals hospitals and/or practices, and if each has its own EHR system that doesn't necessarily communicate with the others, it can be a growing headache.