KLAS Report: Epic to Non-Epic Data Sharing is Real, but Challenging

Providers using non-Epic clinical systems say that while it isn't easy, they are able to share data with Epic, according to a recent report from the Orem, Utah-based KLAS.

As part of this study, KLAS interviewed 28 providers about their experiences with sharing data between the Verona, Wis.-based Epic and non-Epic systems. Some of the areas looked at include the ease of interoperability, the stresses associated with sharing clinical data, and the methods currently being used to share the data.

For the report, "Epic HIE 2014: Everywhere, Elsewhere, or Nowhere Else?" KLAS validated 27 unique instances of Epic customers sharing data with providers using other electronic health records (EHRs). Four out of five are doing so through an intermediary such as a non-Epic health information exchange (HIE) or HISP solution. One out of five is achieving interoperability directly between EHRs. In most cases, information is delivered in a CCD format via industry-standard protocols for pushing (XDR) and pulling data (XCA, XDS.b).

While interoperability standards are supposed to facilitate sharing, most say significant effort is needed to bridge the gap between vendors’ unique implementations of those standards. HIE organizations and non-Epic providers say Epic is capable but inflexible, and that other vendors must meet Epic where Epic stands. This report did not compare standards adherence, but for providers, variability among vendors underscores the value proposition of intermediary HIEs and HISPs.

For Epic end users, sharing with other health systems is a stress-free experience, the report found. Epic handles the configuration, and then the already-familiar Care Everywhere tool suddenly has access to outside data. For non-Epic providers, interoperability is often a bumpier ride. When a vendor does not already support the standards Epic uses, providers often face extensive development and expensive interfaces. Once interoperability is in place, usability varies for non-Epic users: some enjoy easy access to Epic data inside their own EHRs, but others must use HIE portals outside their clinical workflow.

While sharing with other Epic facilities incurs no extra charge, providers mentioned that it does result in new volume-based fees. Some objected to such charges on principle, but most cost-related feedback centered on interfaces—whose costs were seen as reasonable when coming from Epic but prohibitive when coming from other EHR vendors.