In order for the healthcare industry to move toward preventive care and population health management, clinical information needs to flow freely across networks and between hospitals and physicians. For this reason, healthcare organizations need interoperability amongst their technology. However, the industry remains well behind others when it comes to seamlessly and securely communicating and exchanging data.
While the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) has focused the latter stages of its meaningful use program on greater interoperability, recent criticism has suggested that electronic health record (EHR) systems certified for use in Stage 2 of the program are often incapable of exchanging patient health information with other EHR systems, IT vendors and healthcare industry representatives.
As such, although interoperability is poised to radically transform the healthcare system, achieving it poses unique challenges. To discuss these challenges as well as ways the industry can become more interoperable, Joyce Sensmeier, vice president of informatics for the Healthcare Information and Management Systems Society (HIMSS), recently spoke with HCI Associate Editor Rajiv Leventhal. Sensmeier is also president of IHE (Integrating the Healthcare Enterprise) —a national deployment committee of IHE International—an organization that facilitates efforts for fostering the national adoption of a consistent set of information standards to enable interoperability of health IT systems. Below are excerpts of that interview.
What do you think of the recent criticism pouring in concerning interoperability in healthcare?
Right now, provider organizations just aren’t getting much assurance with products. But I think that’s the next wave. If we can provide those products with the capability inside to be interoperable, and the providers that purchase those products can be assured and realize that it works—that it’s more or less plug-and-play—that’s a huge step forward. Our end goal is that every clinician, patient, and person has access they need to their healthcare where they need it. And of course that it’s secure and private.
So is the onus mainly on the vendors?
It’s a shared responsibility—we all have a role. The government has a role, vendors have a role, professional societies have a role, and standards developments organizations have a role. We haven’t all been working together on the same goals—that is what has been missing. Right now, there are too many siloed efforts. We need a restart and figure out how to achieve this working together. That’s not done by reinventing the wheel, but by working together and figuring out what’s there and how we can leverage it.
What are the biggest barriers that are holding the industry back from becoming more interoperable?
Well, agendas get in the way. Each of those groups I mentioned has their own agenda. While meaningful use has been a driver, it has also created a big challenge because when the government says, ‘This is what needs to happen’ and creates incentives for that, of course that will attract everyone’s attention. As a result, a lot of resources and effort go towards accomplishing those goals. HIMSS responds, the vendors responds, the providers respond, but Stage 2 is still such a subset for where we need to go. In my opinion, a lot of effort is being put forward for such a small piece.
I would love to see the government be the coordinator and convener of the different groups—not just setting the agenda themselves, but getting input from everyone. I want them to say, ‘Here is the vision, so what can we do and how can we work together to accomplish that?’ And then groups can respond by defining their role.
I think the vendors will eventually align. They have been getting hit with criticism that they’re not working towards interoperability, but I have to disagree. IHE USA sponsors Connectathon (a cross-vendor live testing event) as a piece of the testing process. Epic has been very active in coming to Connectathon and making systems interoperable with others. They have made efforts; they are an example of the vendors trying. Of course they want to sell their products, but if priorities are identified and if providers can help with that pull, that will align things much more effectively across the vendor organizations.
You have to remember, physicians didn’t get into the industry to be administrators, but rather to do good patient care and move medicine forward. So it is difficult for them. However, surveys have found that 70 percent of providers see interoperability as their biggest challenge. They understand why it’s needed and they want it—it’s just a matter of getting through the painful process to get to that point.
Are vendors working together to accomplish this goal?