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The business and technology obstacles to healthcare interoperability

Chris Nerney
Chris Nerney, Contributing Writer |
The business and technology obstacles to healthcare interoperability

A recent report by healthcare IT analyst firm KLAS offers a sobering snapshot of the current state of interoperability: Despite the widespread adoption of electronic health records (EHR) systems by hospitals and private practices, the vast majority of providers aren’t sharing patient data across networks.

The KLAS report shows that even the EHR vendors best at supporting information sharing enable “deep interoperability” only 26 percent of the time. Yet most providers that are able to routinely exchange electronic data report better-quality care and increased efficiency, according to a National Health Information Exchange and Interoperability Landscape report.

So if the benefits of interoperability are clear, and the desire for interoperability among providers strong, why are only 30 percent of U.S. hospitals routinely finding, sending, receiving and integrating patient data from outside providers, as a recent Health Affairs report shows?

HL7 CEO Charles Jaffe tells Healthcare IT News Senior Editor Jessica Davis that the main reason interoperability is lagging behind expectations is the lack of motivation on the part of vendors.

“Fundamentally, I consider the biggest impediment the business case. Why would I do it?” he tells Davis. “You can’t expect the for-profit vendors to connect everyone on their own dime… Why would I want to share data with my competitor when I’ve been trying to keep data from him for about 10 years?”

Jaffe cites several other barriers to interoperability, including the lack of a security, or “trust,” framework, policies under HIPAA that require the protection of patient privacy, and problems with interpreting data coming from other vendor systems. In particular, he says, lack of a uniform patient identifier has created challenges for HL7’s promising FHIR interoperability initiative.

“We have a lack of clarity in the meaning of the words we use,” Jaffe says. “If we’re having a conversation, you may not hear it correctly. But you may still understand me even with an error. The computer can’t do that.”

HL7 and Intermountain Healthcare plan to host a series of meetings among industry stakeholders later this year and early next year to generate agreement on definitions and terms.