In a world where relationships are sustained over the years, across thousands of miles, through free social media sites like Twitter, Facebook, and Instagram, it is a bit hard to believe that access to our electronic medical records (EMR) is so limited to the hospitals or clinics where we receive care.
Perhaps part of the problem is that many patients aren’t fully aware that interoperability issues exist. In the US, the Department of Health and Human Services Office of the National Coordinator (ONC) and the push for Meaningful Use are driving the interoperability cause, with healthcare institutions often at the mercy of vendors when it comes to their ability to share information with outside entities.
In order to achieve true interoperability, though, patients are going to need to play a role as well.
Imagine what even the London Symphony Orchestra would sound like if each member was reading from a different sheet of music. In a sense, healthcare is largely seeking to overcome this very problem today. Interdisciplinary care teams—physicians, case managers, pharmacists, payers, and even patients and their care takers—have information, but it is not always the same information. Sometimes, it is as if they are all looking at different sheets of music.
A call for standards and collaboration
Interoperability was a hot topic at HIMSS15. The organization’s Interoperability Showcase featured over 100 different clinical information systems and demonstrated how standards-based health information exchange (HIE) systems can enable free access to data, improve patient outcomes, and lower the costs of care.
At the conference, HIMSS released ConCert, an interoperability testing and certification program that sets the bar higher than Meaningful Use and is not affiliated with any specific vendors. It uses the Interoperability Test Tool developed for the Office of the National Coordinator, and is designed to help organizations thoroughly vet new EMR vendors before signing contracts, or to verify that their current EMR system meets the highest standards of interoperability.
Also at the conference, two popular EHR providers, Epic and eClinicalWorks, announced that they would be fully interoperable using the CareQuality network. This interoperability is being piloted at Entira Family Clinics in Minnesota.
We provide our patients with the best care possible, necessitating information from all of their care givers,
said Dr. David Thorson of Entira Family Clinics.
Many of our patients are also seen by doctors at HealthEast Hospital, which could have created challenges due to different systems. Instead, we have a seamless view into our patients’ care, regardless of where it occurred. Knowing that eClinicalWorks and Epic, the technology partners for our organizations, have made interoperability a priority is one of the reasons we selected them.
Americans want interoperability
While they may not know exactly what interoperability means, according to a survey conducted by the Society of Participatory Medicine, 75 percent of 1,011 respondents said it is very important that their health records be easily shared. When asked, 20 percent of respondents indicated that they or a family member had experienced a problem receiving medical care because their health records couldn’t be shared between providers.
I’d guess that many Americans don’t give much thought to their EMRs when they are at their local pharmacy, when their epileptic child is taken by ambulance from summer camp to the closest emergency room with a broken collar bone, or when they seek care for a persistent cough at a retail clinic.
However, these are but a handful of examples in which interoperability—the great symphony of digitally connected caregivers working together for the good of their patients—is important.
We have the technology
Platforms like CareQuality and ConCert exist, and it’s time that all EMR vendors and caregivers put aside whatever special interests they may think they have in their patient data to ensure interoperability for the sake of their patients.
We have the technology. What we need is for health care providers and systems developers to put patient interests ahead of business needs. None of them would exist were it not for the patients.
I’ve written recently about roadblocks to health information sharing as outlined in the ONC’s report to Congress on Health Information Blocking. Although the word patient is in the report 33 times, mostly in regards to ensuring the quality of patient care and safety, not once is the patient called upon to take action.
Do patients really have no role or voice in the interoperability debate?
Shouldn’t we, as patients, be enraged that vendors and providers are blocking the sharing of our data when it could have such a profound impact on the quality of our lives? Which seat in the orchestra should patients have? Patients shouldn’t be the instruments being played by musicians. It’s time to take our place—any place—on the concert hall stage.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.