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ONC study shows progress in EHR interoperability

There has been significant progress in getting health information technology systems to talk to one another, according to a new study on interoperability by HHS' Office of the National Coordinator for Health Information Technology.

The study, “Hospital Electronic Health Information Exchange Grew Substantially in 2008-12,” was published in the August issue of the policy journal Health Affairs. The report was written by five ONC staffers, including the lead author, Michael Furukawa, director of the ONC's Office of Economic Analysis, Evaluate and Modeling, and contributor Dr. Farzad Mostashari, the ONC chief.


Health information exchanges help move healthcare data electronically across organizations within a region, community or healthcare system to speed access to clinical data and improve patient care.

The study looked at American Hospital Association national survey data from 2008 through 2012 for about 2,800 acute care, children's and cancer hospitals. It looked at three areas of inquiry—whether exchange as an activity has increased over time, how exchange activity varies by information and organization type and affiliation, and how electronic health-record adoption, health information exchange organizations and “other hospital and area characteristics” are associated with hospital exchange activity in 2012.

The researchers asked hospitals officials about the exchange of radiology reports, lab results, clinical care summaries and medication lists, whether the information was exchanged within our outside the organization, and whether the exchange was between hospitals or ambulatory care providers.

“Despite substantial growth in EHR adoption and the availability of regional (HIEs), exchange activity has been relatively limited in hospital settings,” the report authors said. “In general, limited interoperability across vendors, low motivation to share information in a fee-for-service payment environment, and the high cost of interfaces remain substantial barriers to widespread health information sharing.”

That said, researchers found that hospitals' participation in health information exchange grew during the study period. In 2008, 41% of hospitals surveyed reported they were engaging in health information exchange. By 2012, it was 58%.

In 2012, 51% of hospitals exchanged clinical information with unaffiliated ambulatory-care providers, but only 36% of hospitals exchanged with other hospitals outside their organization, the report said.

Increasing interoperability is a key goal of the so-called Stage 2 meaningful-use requirements under the EHR incentive payment program. Those requirements kick in for hospitals Oct. 1, and for physicians and other eligible professionals Jan. 1, 2014.

Follow Joseph Conn on Twitter: @MHJConn






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