But Erica Galvez, the interoperability and exchange portfolio manager at the Office of the National Coordinator for Health Information Technology, and several committee members sounded optimistic notes about interoperability.
“There is a base from which we can build,” Galvez said. “We're not starting from zero.”
Further, according to ONC head Dr. Karen DeSalvo, the demand for exchange is building from providers and the public.
“It's palpable that the data is pushing at the doors,” DeSalvo said, with consumers “picking at the lock.”
The number of directed exchange transactions by healthcare organizations through health information exchanges has grown by 225% to more than 226.6 million transactions between the second quarter of 2012 and the fourth quarter of 2013, Galvez reported in a slide presentation.
Exchanges based on queries, a more technically challenging form of interoperability, have risen even faster, by 334% to 7 million, over the same period, Galvez said.
More than half (51%) of hospitals are able to query patient health information electronically, Galvez said, while 41% were able to send and receive secure messages with patient information to “external sources.”
Physicians are lagging hospitals, somewhat, however, she said. In 2013, only about one-third of physicians could exchange different types of patient data such as lab results (36%), medication lists (34%) and problem lists (33%).
Interoperability, or the lack thereof, has been the focus of growing criticism of federal efforts to promote the use of electronic health-record systems to improve quality and reduce the cost of care.
The success achieved in electronic prescribing, another form of interoperability, ought not be ignored, said Arien Malec, a vice president at RelayHealth, a health information exchange software developer, a McKesson Corp. health IT subsidiary. “The last time I looked at the SureScripts, (electronic prescribing data) they were doing 6 billion transactions. In our own business, we recently passed the billion transaction mark we're facilitating on an annual basis.”
But Malec added that the group needs to understand the frustrations of providers and “to fairly confront the challenge where out-of-the box across-vendor interoperability stands.” It needs to develop a plan that promotes “cross-vendor access to patient records” and creates an infrastructure to promote the access to data by the growing number of mobile apps.”
Follow Joseph Conn on Twitter: @MHJConn