Most hospitals are not sharing electronic patient data—and those that are primarily send and receive flat files that are difficult to integrate into clinicians’ work flow processes, according to a new study published in Health Affairs.
Researchers used data from a national hospital survey done by the American Hospital Association in 2014 and 2015. They used responses to survey questions to assess hospital engagement in the Office of the National Coordinator for Health Information Technology’s four domains of interoperability:
- Finding data;
- Sending data;
- Receiving data; and
- Integrating data into their electronic health record without manual intervention.
“We assessed progress in each of the four domains and among hospitals engaging in all four, as well as evaluating what types of hospitals are becoming newly interoperable,” says study lead author A Jay Holmgren, a doctoral student in health policy and management at Harvard Business School. “Finally, we evaluated the association between each of those domains and hospital availability and use of outside patient data for delivering care.”
In 2015, less than one-third (29.7%) of hospitals had achieved at least some proficiency on measures of “interoperability,” the term for electronic access to and integration of data from different providers. That was only a slight increase from the year before, when this measure stood at 24.5%, according to the study. When the researchers looked at a year’s worth of data from the larger sample of hospitals who responded to the survey in 2015, they found that 43% reported that outside patient information was available electronically when necessary, but more than one-third reported that they rarely or never used it.
The most common barrier these hospitals reported to using outside information was that their clinicians could not see it embedded into their own system’s electronic health record.
A long way off?
“We’re a long way from routine electronic patient data sharing and nationally interoperable healthcare system,” says Holmgren. “Previous research has shown that robust interoperability could deliver significant savings by reducing duplicative utilization, and improve patient satisfaction with their healthcare by ensuring they don’t have to endure redundant testing. Interoperability could also ensure that the burden of managing their data doesn’t fall on them and their family. Our study shows we’re a long way from that goal, and that our existing systems are focused on just moving data between hospitals rather than ensuring that data usable by clinicians when they need it.”
Holmgren believes that when data is shared, it is rarely in a structured format that makes it easy to integrate and deliver to clinicians when they need it.
“Interoperability can be a powerful tool in managing population health, but only if healthcare organizations invest in their IT infrastructure and ensure that outside patient data is presented to clinicians in usable ways,” he says. “If we want clinicians to have access to all relevant patient information when they need it, managed care executives should push both provider organizations and EHR vendors to prioritize integrating outside data so that its available in usable, actionable ways.”
There were a few bright spots that reflect new ways of delivering care, the study notes. The patient-centered medical home model was associated with a higher likelihood that the hospital had outside electronic medical records available and that they were being used by clinicians.