CHIME/KLAS Survey Finds Interoperability Advancing in U.S. Healthcare
A report released on Jan. 26 by the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) and the Orem, Ut.-based KLAS Research is finding that both providers and software and hardware vendors in healthcare are making progress in advancing interoperability.
In the introduction to “Trends in EMR Interoperability,” the CHIME and KLAS leaders note that “KLAS has formally measured interoperability since 2015, monitoring vendor and provider progress toward achieving deep interoperability that substantively improves patient care. The industry has made steady progress in some areas and leaps forward in others. In partnership with CHIME, this white paper shares 10 interoperability trends that highlight areas of progress and opportunities for industry improvement.”
The core finding of the report is this: “Deep interoperability is progressing, with many organizations poised for significant progress in coming years. The rate of provider organizations achieving deep interoperability has doubled since 2017. The overall rate leaves much to be desired, but signs of progress are visible. Thanks to connections to national networks and more proactive vendor support, roughly two-thirds of provider organizations often or nearly always have electronic access to needed records. This has led to a natural increase in the number of providers who report they can automatically or easily locate those records. But perhaps the most meaningful change has been how easily records are available in the clinical view. Organizations that were previously unable to move beyond the access and location stages of interoperability say vendor development of functionality and usability has made viewing these records much easier. Many are increasingly optimistic that this change will allow record exchange to have a greater impact on patient care in the future.”
And the CHIME and KLAS leaders note that “The report highlights 10 trends in the industry based on data from a 2020 interoperability survey, with comparisons to results from past surveys.” As they note, “The report shows steady progress in some areas related to interoperability and leaps forward in others. A total of 67 percent of provider organizations reported they often or nearly always had access to needed records in 2020, up from 28 percent in 2017. They noted improvements in functionality and usability for tasks like locating and viewing records. Many were increasingly optimistic that these changes will allow record exchange to have a greater impact on patient care in the future. Vendor support of data sharing improved between 2016 and 2020, with the biggest gains between partnering organizations using different EMRs,” they add.
KLAS has formally measured interoperability since 2015 to assess the adoption of solutions with a focus on frequency of use, ease of use, functionality and perceived benefit to patient care. In recent years, federal efforts to promote interoperability have been a lever for removing barriers and facilitating uptake. In 2018, for instance, the Centers for Medicare & Medicaid Services renamed its “EHR Incentive Programs” to “Promoting Interoperability” with an emphasis on interoperability, the exchange of health information across systems and patients’ access to their health data; and the 21st Century Cures Act (Cures Act) includes interoperability and patient data access provisions.
“For digital health to reach its full potential, we need to be able to safely and securely exchange information across the healthcare ecosystem,” said CHIME president and CEO Russell P. Branzell, in the press release announcing the publication of the report “Interoperability is the linchpin. With the Cures Act and other federal initiatives promoting data sharing, we should see even more gains that ultimately will improve patient care. As is evident in the survey results, great strides have been made resulting in remarkable improvements. This required hard work for all parties involved and they should be congratulated on their collective efforts.”
“While there’s always room for improvement, we were glad to see provider organizations report progress in data sharing across disparate EMRs,” said Adam Gale, president of KLAS, also in the press release.. “Many EMR vendors have partnered with customers to push interoperability forward. Some have made a strategic decision to focus their efforts on specific aspects of interoperability, such as FHIR (Fast Healthcare Interoperability Resources). Now we must continue to expand that interoperability beyond the EHR and ensure we truly impact the care of patients.”
Other key findings:
• Ambulatory clinics and smaller acute care hospitals are connecting more with affiliate hospitals’ EMR solutions.
• Respondents are more or less evenly split over whether they get sufficient support from EMR companies to be successful. Cost posed the most frequently mentioned barrier, followed by a lack of a thorough understanding of provider workflows and organizational needs along with a lack of technical readiness.
• 39% of respondents considered public health information exchanges the most valuable method for accessing patient data, while 36% chose national networks.
• Patient-facing apps are the most commonly used tools, although app use is still in its early stages. More organizations report using proprietary application programming interfaces (APIs) than FHIR APIs, with patient-facing tools the most common use for both types.
• When asked what the top interoperability use cases EMR companies should focus on in the next two to three years, the majority of respondents recommended enhancing patient record exchanges. Many also suggested capabilities to support population health and social determinants of health.
