More than 95 percent of hospitals and nearly 90% of office-based physicians have adopted an electronic health record (EHR) system, according to the Healthcare Information and Management Systems Society (HIMSS). EHRs are designed to provide access to complete and accurate information, allowing patients receive better medical care. Medical transcription outsourcing is a reliable strategy to improve the quality of EHR data.
Now that EHR adoption is widespread, physicians are looking to optimize EHR use at the point of care. EHR interoperability, which will allow seamless data exchange, is a key element in such optimization. Healthcare facilities often need to interact with each other in order to share patient information and EHR interoperability is necessary to make this possible. Interoperable EHRs enable allow patient information to be shared electronically between different EHR systems and healthcare providers, enabling physicians to ensure continuity of carepatients as patients move in and out of different care facilities.
So what are providers doing to address EHR interoperability challenges? When asked this question in the recent CCM survey, 60% of respondents who included informatics, business, and clinical staff, said that their organizations were moving to a single, integrated EHR. However, a recent report from HIT Consultant points out that interoperability challenges will continue to exist even if organizations implement a single EHR system.
The American Academy of Family Physicians (AAFP) defines an integrated EHR as one that is integrated with practice management software. The AAFP states that typical choices include purchasing a fully integrated product which performs all the functions of practice management software, or a stand-alone EHR which is compatible with an existing practice management system.
Interoperability involves aggregating the rich data generated through EHRs by health plans, health systems, vendors, and patients, analytic systems, and leveraging that data to improve patient diagnosis and treatment. However, even with widespread EHR adoption, interoperability continues to be a major challenge. A Health Affairs study reported that, as of 2014, only about one-fifth of U.S. hospitals were engaged in all four elements of interoperability – finding, sending, receiving, and integrating information (www.healthanalyst.com). According to new survey research from the Center for Connected Medicine (CCM), less than 40% of healthcare executives believe that their organizations successfully share clinical data with external health systems, payers, and other partners, notes the HIT Consultant report.
The HIT Consultant report identified several reasons whymoving to a single EHR will not address all the challenges of achieving true interoperability in healthcare:
- Small practices may not be able to afford moving to a single EHR system: Interoperability will work only if all providers adopt a single EHR across a network of both employed and associated physicians. Implementing a single system may be possible and practical from an IT perspective within a hospital system. But the survey found that only 14. 40% of practices with 1-3 physicians use big systems like Epic or Cerner. Smaller practices typically use self-developed or small vendor EHR systems and will be unlikely to move to a single system due to financial constraints.The report says that adopting a single system across the entire network of providers is not practical or possible due to the expense and disruption it would involve.
- The same EHR may have different codes for a particular condition: Even if health systems have implemented the same EHR, they may be using several codes to report a particular condition. The HIT Consultant report cites the example of a hospital system that had implemented a single EHR and has 18 different codes to document a mammogram.
- Documentation methods by practice setting: Providers may use different clinical documentation approaches. While some may document diagnosis and treatment in detail and type a narrative into a note, others may rely perform data entry using the drop-down menu or structured fields in the EHR. If a field is unfilled, relevant history would be missing, and this can affect data integrity and care.
- Semantic interoperability is a challenge even with a single EHR: The HIT Consultant report notes that several common documentation issues can limit interoperability. These include:
- use of local versus standard terminology libraries
- entering free text instead data capture via the structured fields
- using the wrong unit of measure such as a percentage instead of a count
Moving to one EHR won’t solve these issues that will affect downstream use by both software and human users. Proper interpretation by all users and the software system is crucial for interoperability to work. - Need for interoperability across the entire ecosystem: Implementing a single EHR will not help with interoperability across the vast ecosystem of systems and applications. Interoperability means supporting healthcare processes in the single-use case of care coordination as well ascollecting and communicating data from pharmacy systems and other parts of the supply chain captured at the point of care with disease registries, clinical trial systems and so on.
Research has shown that both providers and patients see EHR interoperability as crucial for high-quality care. As the industry strives to overcome the challenges to interoperability, EHR-integrated medical transcription services are a valuable tool for ensuring timely and accurate updating of health information. Experienced medical transcription companies are well-equipped to provide accurate and timely EHR feeds, which is critical to enhancing the quality of care.
