ME: Interoperability is important, but doctors are frustrated with the slow progress. Will doctors ever see the day when all their EHRs can “talk” to one another?
NP: Doctors have a right to be discouraged with our lack of effective interoperability. It is easier to transfer a dollar on a mobile banking app or connect two telephones across the globe than it is to transfer medical data; healthcare is clearly behind the curve. Data access should be similar to electricity – everyone has their own devices powered by the same electrical current. However, everyone in healthcare has their own product, and there is no requirement for them to speak to one another. A small number of large EMR systems still rule the healthcare IT landscape, controlling the ability to access patient information and constraining the ability to integrate easily.
Healthcare has never had a normal standard for these processes. The key to a world in which patient data is easily accessible and shareable is collaboration among all players in the industry. Health IT is only as effective as its reach, and its reach only goes as far as the ability to work together. While market pressures tend to encourage competition, true integration and smooth patient data transactions will be achieved only if the various players in the industry are incentivized to do so. However, there is reason to be optimistic as previously silent stakeholders begin to speak out and call for collaboration in response to overwhelming industry frustrations.
ME: With the current state of technology and interoperability, what are some ways physicians can obtain the data they need to successfully participate in value-based care programs, such as MIPS?
NP: There are several approaches physicians can take, with varying costs and benefits associated with them. Having electronic data to extract and submit is the basis of participating in any of these quality incentive programs. Certainly, installing an EMR system in the physician practice is essential. There have been financial incentives for installing these over recent years and any financial assistance in this arena is useful. If there is a community-based Health Information Exchange (HIE), it is useful to subscribe to this. The system provides connections to patient data from other encounters and providers.
These approaches support participation, but not necessarily interoperability. Probably the best approach to interoperability is to participate with a health system that has good vision and infrastructure to support interoperability. Often health systems offer to support or partially support ambulatory EMRs to assure interoperability of information for their patients. The larger medical groups often can fund systems to support their data needs. It is the smaller groups of physicians that are challenged with funding these systems and the personnel to manage them. There is no simple answer to the difficult and expensive realities of collecting and submitting data on patients, which is true for small physician practices and large integrated health systems alike.