News Feature | October 17, 2014

ONC Report Reveals Continued Barriers To EHR Interoperability

Christine Kern

By Christine Kern, contributing writer

HTO_Virtual_Health

An ONC report shows increased use of EHRs, but also demonstrates serious hurdles remain.

The ONC released its latest report on the progress of electronic health record (EHR) adoption, revealing that while progress has been made many serious hurdles remain.

The report argues there has been substantial growth in the use of EHRs since the passage of the HITECH Act, citing 2013 figures that “59 percent of hospitals and 48 percent of physicians had at least a basic EHR system, respective increases of 47 percentage points and 26 percentage points since 2009, the year the HITECH Act was signed into law.”

It also asserted there is “widespread participation” in the EHR Incentive programs among eligible hospitals and professionals, with 75 percent of the nation’s eligible professionals and 92 percent of the eligible hospitals and CAHS receiving incentive payments as of June 2014.

And yet, key barriers remain, the report admits. The shift from EHR use to data sharing seems to be the sticking point.

“Electronic health information is not yet sufficiently standardized to allow seamless interoperability, as it is still inconsistently expressed through technical and medical vocabulary, structure, and format, thereby limiting the potential uses of the information to improve health and care,” the report notes.

In 2013, 14 percent of office-based physicians shared patient information with providers outside their institutional walls and 39 percent shared information with any physician, even those inside the same institution. Forty-two percent of hospitals electronically shared clinical-care summaries outside their systems, a rise of 68 percent since 2008. In addition, 55 percent of hospitals shared radiology reports outside of their systems, and 57 percent laboratory reports.

The report concludes while progress has been made, attention must be paid to efforts to improve and expand interoperability nationwide. In 2013, more than 6 in 10 hospitals exchanged clinical data with healthcare providers outside of their system, while only 14 percent of physicians did the same.

The report states that Stage 2 of the EHR Incentives Programs should act as the catalyst for further exchange of clinical information across the healthcare landscape. A central requirement of State 2 is for eligible hospitals and professionals to provide a summary of care record for more than half of their transitions of care.

Beyond continued support of the EHR Incentive Programs, HHS has committed itself to the promotion of “widespread adoption and use of health IT to support better care, better health, and improved efficiency through collaboration with public and private partners, the development and integration of policies and technical standards, and investments to improve health IT usability and safety.”

Moving forward, HHS proposes:

  • New HHS regulations and guidance on existing programs that will enable a patient’s health information to follow them across care facilities with appropriate privacy and security.
  • HHS programs to advance HIE across providers in the continuum of care.
  • HHS efforts to collaborate with stakeholders to develop an “interoperability roadmap that improves existing health information networks, and scales approaches for fluidly exchanging health information across vendor platforms to support a broad array of transitions of care and public health.”

HHS efforts to align health IT standards for quality measurement and improvement.