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EHR vendors and hospitals lagging on interoperability: report

by Lisa Chamoff, Contributing Reporter | August 03, 2015
Health IT Population Health
Electronic health record (EHR) vendors are falling well short of the goal of interoperability and are actually designing systems that perpetuate health care organization “data silos”, according to a new report from Chilmark Research.

It’s something that will have to change in the shift to value-based reimbursement, the report states.

The report, “Moving to Open Platforms: EHR Vendor Strategies and Assessment”, provides an overview of several of the major EHR vendors' limited interoperability capabilities and looks at how interoperability has been hampered by limited adoption of application programming interfaces, which allow different software programs to exchange information. Vendors worry that by opening applications up to developers, they risk losing their customers to a competitor, according to the report.

Health care organizations also have a monetary interest in keeping data, said Brian Murphy, a Chilmark Research analyst and the report’s lead author.

“The fact that it took an act of Congress to put these products in people’s hands speaks to the problem,” Murphy told DMB News. “Patients can go anywhere. Vendors and hospitals have in interest in [data sharing] not happening. They’re doing the bare minimum and they’re doing what they need to do in order to continue to get paid.”

There are also privacy and security concerns, but many of those are unfounded, according to Murphy.

“There’s all kinds of information sharing that has no kind of HIPAA concerns,” Murphy said.

The report details the work of several of the major EHR vendors, including Allscripts, Epic, and Cerner, noting that while they are working toward interoperability, there’s a long way to go.

The report urges EHR vendors to follow the lead of mainstream technology companies, including Google, Amazon, Microsoft, and Salesforce, that take a platform-as-a-service approach. Salesforce, for example, provides an easy way for developers to build and deploy applications on the company’s cloud infrastructure, leading to the development of millions of applications. A similar set-up in health care would allow developers in hospitals’ internal IT departments and independent software vendors to make changes and add value to the software platforms.

EHR vendors have traditional partnership programs with independent software vendors instead of the “app store” approach on the consumer web and, increasingly, in the B2B world, according to the report.

“Today’s EHR users are familiar with consumer and mobile applications and now expect similar levels of usability and cross-application data availability from [health care information technology],” the report reads. “EHR vendors, in every care venue, are out of step with these standards. The time is right to more closely examine the potential benefits of an open, API-based platform for application development and deployment in health care.”

Fast Healthcare Interoperability Resources (FHIR) is described in the report as offering the most potential to provide real-time access to data across applications and organizations, but the report noted that it will take several years for FHIR-based offerings to become generally available and for its effects to become widespread.

Murphy noted that the EHR products on the market would not achieve true interoperability until incentives change.

“It will be improved to the extent that the payment system doesn’t reward them from hoarding data,” Murphy said.

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