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Top questions healthcare organizations must ask before choosing a new EHR in 2019

By Elizabeth Buckle

Electronic health records (EHRs) held much promise when first introduced, making it easier for providers to access patient data and serve as the foundation for improved healthcare delivery and outcomes. But now, nearly a decade since the Health Information Technology for Economic and Clinical Health (HITECH) Act incentivized their adoption, many believe EHRs have yet to reach their full potential.

Why hasn’t more progress been made? Some may attribute this to a fragmented industry, flush with competing technologies and conflicting approaches. This has prevented optimal implementation of EHRs, leaving providers and patients frustrated by the limitations they still face.
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At the heart of this frustration is interoperability. In fact, a recent survey by Deloitte found interoperability is a top concern among primary care and specialty physicians, and 62 percent said they’d like their current EHR system to be more interoperable.

Many challenges remain
To alleviate these concerns, the industry has to first overcome a variety of barriers:

Standards – Organizations tend to interpret interoperability standards differently, or do not adhere to standards-based data exchange at all. This can slow down the process of connecting systems for data sharing because there will be a required period of interpretation and mapping that is required to get both systems in sync with each other.

Stakeholders – There are many different stakeholders who all need access to data, including the patient, ambulatory and acute care providers, home health and long-term care facilities, payers, Centers for Medicare and Medicaid Services (CMS), and potentially, other organizations or individuals. Navigating the landscape of different stakeholders and their varying needs can slow down the process of implementing a truly interoperable EHR.

Patient Identifiers – The lack of a unique patient identifier makes it difficult to track one individual in multiple care settings. Typically, a combination of demographic criteria is used to match patients, but that often falls short. Data entry errors and lack of entered data are both common issues that cause patient matching to be a challenge and a burden.

Work is being done by multiple organizations to address these challenges. For example, the non-profit CommonWell Health Alliance is bringing together health IT companies to solve interoperability challenges and break down the legacy silos. Its goal is to foster universal access to healthcare data. Currently 17 of the top 20 EHRs are, or are in the process of getting connected to CommonWell or Carequality, which are developing platform-neutral, vendor-neutral frameworks for connecting health data networks under a common set of nationwide legal, technical and policy rules to support the trusted exchange of data. Carequality has also worked on technical and policy agreements that will enable data to flow between and among networks, platforms and geographies, much like the telecommunications industry did for linking cell phone networks.
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