AHA survey highlights progress/barriers to interoperability

PARCA eNews – Aug. 15, 2015 – A recent ONC analysis of a nationwide survey of non-federal acute care hospitals conducted by the American Hospital Association (AHA) highlighted the near universal adoption of EHRs by hospitals and significant increases in hospitals’ electronically exchanging health information with outside providers compared to past years.

•  Nearly all reported hospitals (97%) possessed a certified EHR technology in 2014, increasing by 35% since 2011.
•  In 2014, three-quarters of hospitals reported that they electronically exchanged health information with outside ambulatory providers or hospitals. This represents a 23 percent increase since 2013 and an 85 percent increase since 2008, the year AHA started collecting this information.

A snapshot of the availability of clinical information among America’s hospitals shows that 41 percent routinely are able to access important health information about a patient during treatment from sources outside their hospital according to the ONC analysis of the AHA data.

Of the one-quarter of U.S. hospitals that are able to send, receive, find and use electronic health data, 86 percent reported that they are able to access important health data about a patient during treatment from sources outside their hospital. This is over twice the national average.

Only 4 in 10 hospitals reported they can integrate information from patient summary of care records into their EHRs, which poses challenges to clinical workflow and information usability. The hospitals cited the limited capability of exchange partners’ to receive information to be the top barrier.

In the executive summary of the AHA report "Achieving Interoperability that Supports Care Transformation" the AHA advisory group outlined actions needed to be taken by both the private sector and the federal government to improve interoperability.

Private Sector Actions

Hospitals, health systems and other providers must identify their priorities and make it clear to vendors that they want efficient and affordable information sharing. 

Providers must: 

• Set an expectation that vendors adhere to standards. 
• Identify the highest priority information sharing activities (or “use cases”) they want their health IT systems to support. 
• Contribute their requirements for testing as the end-users of health IT systems. 
• Invest in standardizing care processes and use of systems. 
• Actively identify and share lessons learned and best practices. 

Federal Government Actions

• Focus interoperability efforts on accelerating exchange of data currently collected. 
• Improve certification, based on more robust testing. 
• Create and support robust testing tools to ensure systems conform to standards that support interoperability. 
• Increase public reporting on how vendors support interoperability and information sharing. 
• Lead selection of standards, including continued development and maturation of needed standards. 
• Actively support adoption of standards by providers. 
• Address patient identification and matching. 
• Rely on existing polices and the incentives of new models of care to encourage information sharing by providers. 
• Adopt a reasonable timeline for change. 

Sources: Health IT Buzz blog, and AHA interoperability resources