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A Look Inside KLAS’ New Approach to Measuring Interoperability

December 19, 2016
by Rajiv Leventhal
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In October 2015, Orem, Utah-based KLAS and several major health IT stakeholders collaborated toward the creation of a viable measurement tool of interoperability, which was then used as a base for KLAS’ Interoperability 2016 report this past October.

The 2016 report, inclusive of interviews with more than 500 electronic health record (EHR) end-users, focused on the “four bases” of interoperability, which were that patient records must be (1) available, (2) easy to locate, (3) situated within the clinician workflow, and (4) delivered in an effective way that facilitates improvement in patient care. KLAS found that true “home runs” in which all four criteria are met were only reported by 6 percent of providers surveyed. Provider respondents were also asked about their experiences with specific health IT vendors.

Two key members of this work were Bob Cash, vice president of provider relations at KLAS; and Tim Zoph, chair of the KLAS Interoperability Measurement Advisory Team (IMAT). Zoph also spent years as a healthcare CIO and is now client executive and strategist with Naperville, Ill.-based consulting firm Impact Advisors. While the report’s core findings can be read here, and access to the full research can be gotten here, Healthcare Informatics wanted to get a “behind the scenes” look at the process in developing the tool to measure interoperability, what to take away from this year’s report, and what could be in store for future KLAS reports. Below are excerpts of interviews with both Cash and Zoph.

Last fall, KLAS and a bunch of major health IT stakeholders collaborated around a tool to measure interoperability. Then you published a comprehensive report on data sharing. Can you take me through this process?

Cash: Well, it wasn’t easy. I should give credit to four key leaders in the industry on the provider side, at least for the initial draft of the report’s questionnaire—John Halamka, M.D., [CIO of Beth Israel Deaconess Medical Center]; Dan Nigrin, M.D. [CIO of Boston Children's Hospital], Micky Tripathi, Ph.D., [president and CEO of the Massachusetts eHealth Collaborative]; and Stan Huff, M.D. [CMIO of Intermountain Healthcare]. Those four helped us put together the initial draft which we then took to the leaders of the major EHR vendors along with a group of providers last October. And there was back-and-forth battle with that—not as much about the content or context, but about making sure that what we asked would get to the issues and concerns in the industry. There was discussion around if we needed to know about the volume of transactions shared, but we opted not to ask about that. It was more about the perception and experience of people using the information.

As far as the creation of the tool, last year we had about 50 percent vendors and 50 percent providers [at our Keystone Summit]. But we had a broader group this year. We had Carequality, CommonWell, HIE [health information exchange] vendors, and representatives from ONC, CHIME, AMIA, AMDIS and the Center for Medical Interoperability. Our vendor representation this year was people who are responsible for interoperability in their organizations, rather than the CEOs and presidents.

Zoph: This process started over a year ago where we put a number of things into motion at a Keystone Summit in Utah. We thought it was important that if we were to put a measurement tool together from both the provider and vendor sides, they must agree on those measurements. So we wanted a collaborative view of what interoperability is. KLAS became a convener; we saw them as a trusted third party to ultimately carry forward whatever we agreed in the measurement framework to do. They were willing to put resources behind the measurement.

We wanted to start with the interoperability around EHRs by bringing together the major providers of EHRs. They all showed up. We had some leading healthcare informaticists and CIOs put together the initial draft of a measurement framework, so there was some pre-work done leading up to the conference. But the goal of the conference was to see if we could get everyone to show up for a multi-day meeting, and use this draft framework to come up with an initial set of measures that everyone could agree on. And then we would have KLAS go out and do its 500 interviews.

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