Barriers Standing in the way of Interoperability

At the recent 2016 U.S. News Healthcare of Tomorrow Conference in Washington, D.C., interoperability was a major point of focus. Essentially, interoperability just means patient data can be shared among authorized practitioners and institutions. The U.S. Department of Health and Human Services is hoping that we will have interoperability between all EHRs by 2024, but it may be easier said than done. Although its almost universally appreciated that interoperability would be a good thing, there are still barriers standing in the way.

Competition between Hospitals:

Obviously, treating patients is at the top of every hospitals to do list and interoperability could facilitate better care, but economic incentives unfortunately get in the way of sharing data. Hospitals in areas with close competition try to keep their information private. This makes sense because they want to detract from patients going to their competition, but this mindset has to change before interoperability can become a reality. Hospitals must remember that the information does not belong to them, but rather to the patient. In answer to this issue, The Federal Trade Commission said, the Office of the National Coordinator for Health Information Technology (ONC) should make an effort to align economic incentives to create greater provider demand for interoperable health IT, thereby incentivizing health IT vendors to compete on the basis of interoperability."

High Data Exchange Fees between Competing Companies:

Sharing patient records between disparate EHR systems is currently possible, but it is very expensive. With the amount of companies storing patient data, its no wonder they make sharing records with their competitors very expensiveits an easy way to compete. As noted by a 2015 Politico article, doctors pay $5,000 to $50,000 each for the privilege of setting up connections allowing them to transmit information regularly to blood and pathology laboratories, health information exchanges, or governments, according to more than a dozen sources. $50,000 seems rather extreme, but the federal and many state governments have taken notice of the EHR industrys lack of willingness to work together. In the beginning of April 2016, the Department of Health and Human Services proposed a rule, which would allow them to have direct review of EHRs and a greater oversight regarding health IT. Until the government regulates it, there may be little incentive for companies to stop charging exorbitant prices for data transfers.

Lack of Usability and Frustration:

Beyond the expense of coordinating multiple programs across a variety of platforms, is the inconvenience physicians face when actually integrating EHRs into their routine. Whether its simply entering patient information, trying to share the information, or troubleshooting the software, EHRs can interrupt the doctor-patient experience. These types of distractions inevitably lead to both patient and doctor frustration.

Although technology is intended to streamline a doctors work, there are still shortcomings that must be addressed. For many, technology has produced a barrier, metaphorically and literally, in the form of a screen, between them and their patient. This is troublesome not only because it interrupts the patients visit, but can lead to visits lasting longer than intended, causing less patients to be seen. The strain leads to clinics lamenting over the technological shift rather than seeing the benefits, thus causing more disparity between multiple systems and disciplines.

Interoperability is undoubtedly the future, but until there is financial incentive, a consensus regarding standardization, and a better usability for doctors, the clinical community may well continue to lag behind. The ability to connect patient data exists; there are just a few areas that need to be smoothed out before it will be distributed nationwide.

Max Gottlieb is the content manager of Senior Planning and ALTCS in Phoenix, Arizona. Senior Planning and ALTCS are completely free services. Both organizations provide assistance to seniors and the disabled who need help finding and arranging care services, applying for state and federal benefits, or relocating for care.