Less than half of healthcare providers say their electronic medical record (EMR) vendor cooperates well with other vendors, and only one-fifth are optimistic about multi-vendor industry initiatives such as CommonWell, according to a recent report on interoperability from the Orem, Utah-based KLAS research.
Additionally, 82 percent of the 220 interviewed providers reported feeling at least moderately successful achieving interoperability, but a mere 6 percent of those providers reported having achieved an advanced state. Specifically, Cerner, Allscripts, and Siemens customers mentioned complex, multifaceted connections but did not always rate overall success as high. In contrast, athenahealth, MEDITECH, and NextGen customers feel successful but described common interfaces and less sophisticated capabilities.
What’s more, less than half of providers said their vendor cooperates well with other vendors. Athenahealth was the exception, with almost 85 percent giving above average marks. Epic has recently been scrutinized in the media, but they are among the next five highest performing vendors, along with Allscripts, Cerner, GE Healthcare, and MEDITECH. All had 50-60 percent of customers say they cooperate well. With this backdrop, it’s no surprise that providers are putting little thought or stock into cross-vendor initiatives like CommonWell and Carequality, according to the report’s authors.
Furthermore, some vendors demo fantastic capabilities and wonderful outcomes, but behind the curtain it takes a tremendous amount of work to build and maintain interfaces. Instead of plug-and-play wizardry, providers get to lay bricks. Allscripts, athenahealth, and Epic do the best job of facilitating interfaces and keeping costs down. Vendors rated highest for limiting interfacing costs had only about 55–65 percent of their customers say they did so well or very well, the report found.
The report— "EMR Interoperability 2014: Where Are We on the Yellow Brick Road?"—might come as surprise to some, as healthcare organizations often cite lack of interoperability as one of the main challenges they face. "There has been a lot of public discussion about the lack of interoperability among EMR vendors," said report author Colin Buckley. "The truth is that most providers feel at least moderately successful with interoperability today, but most say that success is due to their own efforts. They wonder how well prepared their vendor will be for the future."
Following the release of the report, Healthcare Informatics spoke further with Buckley about the deeper significance of the study’s findings and the collective state of the industry regarding interoperability. Below are excerpts from that interview.
What are your main takeaways from the comments given by 220 provider organizations on the state of interoperability?
There are two dimensions when it comes to the state of interoperability. From the broadest point of view, a lot of the people we talk to feel pretty successful with what they’ve been able to accomplish so far. And because they are also not working off of a standard of perfection, it’s about what they need to accomplish for today, meaning some sort of internal goal, such as clinical integration or meaningful use. And they feel like they are progressing—more on their own doing than their EMR vendor—but we didn’t see a lot of terrified providers out there.
Most of what we hear regarding interoperability is not very positive. Are you surprised by this study’s findings?
I am. One of the reasons we did this study was to take the temperature of providers. That doesn’t mean there isn’t concern or pressures as they look down the road, however. There is a fair amount of confidence in themselves, but not as much in the technology to meet their needs when they’re ready.
More than 80 percent of providers you interviewed felt at least “moderately successful” achieving interoperability. What do you think that means?
It’s really in the eye of the beholder, but it can be broken up by types of organizations. For example, the EMR vendor you are using can factor into that feeling. For some organizations, their needs for interoperability are fairly modest, and they might be happy with the state of their interfaces, and say that they’re successful. Other organizations have more demanding needs and are trying to reach out to providers in their area and neighboring hospitals, so it’s harder for them to accomplish what they want to.
In terms of vendor rankings for interoperability, what was most significant?
Looking at specific vendors, in the commentary we got back from providers, Cerner is a vendor that had some of the more complex interoperability [problems] going on with their customers. Maybe it’s not surprising, but the overall feeling for success for Cerner is not as high as some others. It’s easier to feel successful when you have a simpler problem to solve.