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Despite Small Steps, EHR Interoperability Remains Elusive


 

FROM A SWEDISH MEDICAL CENTER SYMPOSIUM

SEATTLE – True electronic health record interoperability, with seamless information transfer between systems made by different companies, is still years off, agreed panelists discussing health information technology at the Swedish Medical Center Symposium "Innovation in the Age of Reform."

They also agreed that when interoperability comes, it will quickly identify emerging public health problems, address outcomes disparities, and lead to new drugs and other treatments because connected systems will, in effect, function as a massive clinical database.

"We would be a failure as an industry if we weren’t [eventually] able to find problems with chloromycetin and thalidomide [for example] much earlier" using the new technology, said Judith Faulkner, founder and CEO of the electronic health records (EHR) company Epic Systems. "I would hope we can focus on things such as autism and figure out the causes."

The lack of EHR standardization stands in the way of such potential, panelists said. The tens of thousands of data elements in Epic’s database are different from the elements in the Cerner database, which are different from those in the AllScripts database, said Peter Neupert, corporate vice president of Microsoft’s health solutions group.

One of the reasons, he said, is that vendors have little economic incentive to share information and standardize their approaches.

If an interoperability solution is not found, however, "China’s going to figure it out and export it here, or India is going to export it here," said Mr. Neupert. Those countries are developing health information technology to sell at lower prices than U.S. developers’ prices, he said.

Microsoft’s HealthVault allows consumers to store health information online for quick access wherever they’re treated, among other functions. Amalga, another Microsoft product, allows organizations to aggregate and mine clinical data.

Epic is developing Care Everywhere, a system to transfer medical records – with patients’ consent – across different EHR systems. It’s also working on a Connect the Docs system to facilitate communication and expertise-sharing between physicians, Ms. Faulkner said.

The federal government is working on interoperability fixes, too, said panelists. The current incentives for physicians and hospitals to install EHR systems include the goal that they eventually will be interoperable.

Among other measures, the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act funds the formation of regional health information repositories that can be queried by providers. The Office of the National Coordinator for Health Information Technology created by the act is developing a secure, e-mail–like system over which providers can exchange patients’ medical information.

HITECH , however, "is a start, not a finish," said Rep. Jay Inslee (D-Wash.), also a panelist. He agreed that the challenge remains in "making sure systems can work together."

Mr. Neupert expressed confidence. "Computing is going to get 1,000 times faster in the next 10 years. With cheap storage and 1,000 times the processing power, we can translate stuff in Epic’s data store [and] Cerner’s data store and every other data store into a meaningful operational data asset. It’s going to be really fabulous for individuals."

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