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Similar challenges plague different approaches to interoperability

I recently led an interoperability discussion among healthcare executives. They came from different organizations, many of which faced significant transitions recently. They used a variety of electronic health record (EHR) vendors and diverse approaches to data exchange. Despite all of these differences, there are remarkable similarities in their interoperability journeys.

Do we trust the data?

Our session included an interactive component, where participants could respond to survey questions in real time via their smart phones. It gave us a quick way to gauge how the group felt about aspects of interoperability.

We asked about their primary concern with data that they use to manage patient populations. Data quality and trust concerns were at the top of the list. The dialogue that followed that survey question focused on trust in terms of cybersecurity, which is certainly top of mind these days.

However, trust can have a different meaning when it comes to pulling in data from different sources. We’ve learned from our clients that clinicians need to be confident in this information for it to be useful. When another data source reports a patient has an allergy, for example, a clinician needs to know if that is stale information, or is it newly updated?

One field that drives the success of interoperable information more than anything else: who documented that element? Is it a trusted clinician who is known for accurate diagnoses? Ultimately for interoperability efforts to be successful, we must establish trust in the security and reliability of the information provided.

How do transitions affect tech?

Almost everyone in the room reported having experienced an organizational transition in the last six months, including acquisitions, mergers, joining an Accountable Care Organization (ACO) and tackling shifting payment models.

The number one challenge reported as a result of these transitions is data migration. Moving information from one system to another can be a key component of health systems’ strategies to maximize the value of a merger or network realignment.

One-third of the executives we spoke to said that the challenges of transitions have caused them to consider moving to a new EHR system. Frankly, I thought this number would be higher. I was curious if organizations who had moved to a single EHR system would report finding greater success with interoperability than those who had not. But no matter if they chose a single vendor or implemented an interoperability platform – everybody was in the same boat.

A monolithic vendor is not the answer

Even organizations that have gone to a single vendor are reporting that one system will never tell clinicians everything they need to know about the patient. There will always be another system to connect, and organizations will still need to make sense of the data when it arrives.

In reflecting on this meeting, I’m reminded of another conversation I had with a CIO of a large hospital system. She oversees dozens of instances of the exact same EHR across more than 150 hospitals. Even though it is the same EHR, the data is different in every single instance. She said, “I can’t count anything. I can’t tell you how many patients came to our ED [emergency department], because the instances all call an ED stay by a different name.” Something as simple as managing “intra-operability” within a system is not simple when there’s no synchronization.

These health systems share a common goal. They are trying to manage their populations more efficiently by delivering the right care to the right people at the right time. The key to success is to use data as an asset at the point of need.

Editor’s Note: Read more commentary and findings from this meeting in a recent article, 26 healthcare executives weigh in on data quality, interoperability and more.

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