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Almost all US hospitals using EHRs, but barriers hamper interoperability

by John R. Fischer, Senior Reporter | March 14, 2023
Health IT
The ONC says 96% of U.S. hospitals and physician offices have adopted and are using EHRs.
The Office of the National Coordinator (ONC) for Health Information Technology says that 96% of U.S. hospitals and physicians offices have traded in paper-based medical records for electronic health records.

The agency discussed this in a report released March 7 assessing the 21st Century Cures Act (2016), which created incentives for electronic health information sharing and adopting EHRs to improve interoperability, and the Health Information Technology for Economic and Clinical Health Act (HITECH Act) (2009) for the adoption of health information technology.

“HHS regulations supporting care delivery and patient access through information sharing policies and ONC standards, and technological requirements, are modernizing how information sharing informs patients, caregivers, healthcare providers, and other members of care teams,” wrote Micky Tripathi, national coordinator for health IT, in the report.

Medium, large and noncritical access hospitals and providers in suburban and urban areas participate in health data exchanges the most. Nearly all hospitals, ambulatory centers and physicians offices use solutions certified under the ONC Health IT Certification Program, and the number of patients using electronic portals to view health information is growing.

Still barriers to overcome
Diverse priorities, resources and business models among different patient populations nationwide have made it harder for some providers to fully embrace interoperability. Long-term, post-acute care and community providers, for instance, were ineligible for HHS incentive payments that encouraged EHR adoption, causing them to lag behind.

COVID-19 and lack of substantive resources for public health IT also prevented healthcare systems from fully implementing certified health IT solutions and obtaining reliable population data to care for vulnerable patients and address equity gaps. This has prevented the U.S. from establishing uniform nationwide network interoperability across care continuums.

“Patients see providers across practices, counties, and sometimes even states. The information sharing ecosystem must be able to support information being available to inform their care wherever they are seen,” said Tripathi.

Creating a uniform interoperable network
The ONC recommends that equity be a key component in health IT designs to improve equal access to information and health outcomes. It also says providers should work with the CDC and other HHS agencies to modernize public health data systems with health IT standards, and educate patients and their communities about information blocking policies to encourage appropriate information sharing.

Other suggestions include implementing TEFCA for a nationwide policy and technical infrastructure for information sharing across networks; advancing standards to support data sharing across all care settings via certified health IT systems; and coordinating with federal agencies to ensure ONC-adopted standards support EHI access, exchange, and use across federal programs and health IT systems.

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