Most healthcare providers feel pretty good about the progress they've made on the path toward interoperability of their healthcare information technology, even though the majority of them know they still have a long way to go to achieve full information exchange, according to the results of a survey of health information technology users.
Asked about their overall success in achieving interoperability, providers surveyed appear to measure their progress “based on their unique goals” rather than achieving some generally accepted milestones along the way, researchers report.
Thus, 82% of providers surveyed indicated they felt their organizations were either very successful or moderately successful in achieving their overall interoperability goals. But only 6% indicated they had achieved a state of “advanced interoperability,” defined as “multi-faceted interoperability beyond common interfaces.”
For its report, “EMR Interoperability 2014: Where Are We on the Yellow Brick Road?” KLAS Enterprises, an Orem, Utah-based health IT market researcher, this summer queried with 246 hospital and ambulatory-care providers who use health IT systems.
“If you read the news and the blogs, you'd think the house was burning down with regards to interoperability,” said Colin Buckley, director of research strategy at KLAS and a co-author of the report. “But if you talk to providers, they'll say, 'Yeah, things could be better,' but their house is not burning down and they think they're on the right path.”
The survey results echo data released last month to federal health IT policy advisers.
Asked which interoperability platform or feature has most improved care delivery within their organization from a list of seven technologies or approaches, nearly a third (32%) of respondents answered “none.” Another 16% picked an integrated EHR, leading KLAS researchers to combine the two percentages and conclude that almost half of providers hoped to avoid the issue of interoperability because of its “complexity and pain.”
For those providers who have bitten the interoperability bullet, 20% cited health information exchanges or health information service providers as the interoperability platforms that have most improved-care delivery. Having significantly lower impacts were messaging using the federally sponsored Direct protocol (7%) and patient portals (3%).
Not surprisingly, providers using an enterprise EHR, a system with inpatient and ambulatory functions available from the same vendor, gave themselves higher satisfaction scores for things such as interfacing, health information exchange and direct messaging than their peers that used systems made for in-patient or ambulatory care alone.
Bringing exchanged information smoothly into clinicians' workflows seemed to be an Achilles' heel for EHRs across the board.
Provider satisfaction levels for incorporating information exchange into clinical workflows scored the same between enterprise systems and ambulatory systems, with only 49% saying they were “very well” or “well” satisfied with their performance. Satisfaction scores for bringing exchanged information into the workflow was even lower—39%—for customers of inpatient-only systems.
KLAS cited Allscripts (with its Sunrise EHR), Cerner, Epic and Meditech as vendors of these fully integrated systems; McKesson and Siemens as vendors of inpatient only; and Allscripts (Touchworks), Athenahealth, eClinicalWorks, GE Healthcare, Greenway and NextGen, for ambulatory only.
Athenahealth ranked well above the pack with 86% of its customers saying they were “very well” or “well” satisfied with how their vendor cooperated with other organizations and their vendors in helping them achieve interoperability. Athenahealth also had the highest level of satisfaction from customers when asked whether their EHR made an overall contribution to their success as providers, with more than 90% of its customers reporting it contributed “very well” or “well.”
Epic, recipient of recent negative publicity about interoperability, ranked in the middle of 11 vendors on cooperation with other vendors and placed the lowest of the four enterprise EHR vendors in the survey, but ranked second only to Athenahealth in helping providers achieve overall success.
“That's one of the things that gets leveled at Epic, that they don't want to work with anybody,” Buckley said. “We see Epic right in the middle of the pack” in terms of cooperation with other vendors. “Nobody, except for Athena, stands out, and all of the enterprise vendors fall in that 40% to 60% range.”
“Epic customers say the cooperation (with other vendors) is kind of average, but the feelings of confidence and success of moving toward their goals is quite a bit higher (above 80%),” Buckley said.
“There are things other than interoperability,” Buckley said. “They work at a steady pace and their customers feel safe.”
Long a market leader in EHR sales for hospitals and ambulatory-care practices, “most of that sharing is Epic to Epic,” Buckley said, “but it just so happens that satisfies a good portion of the needs of their customers.”
Follow Joseph Conn on Twitter: @MHJConn