With the government breathing down developers' throats to achieve more interoperability for electronic health records, Kent Gale, founder of the KLAS IT ratings research firm and Micky Tripathi, CEO of Massachusetts eHealth Collaborative, wrangled a dozen competing executives to a summit meeting in Utah earlier this month.
There, they got the EHR developers to stop hissing and clawing at each other long enough to agree on a way to survey and measure interoperability.
Gale said the specter of Congress jumping in and using its own criteria to force interoperability drove everyone at the summit to try to find a private-sector alternative.
The 11-question survey will stick to questions about EHRs for hospitals and ambulatory primary-care practices. It will measure how those customers perceive that products and services help providers meet interoperability goals.
Gale recalls the vendors worked with participating providers to hammer out the final document, which, when brought to the floor, was more acquiesced to than wholeheartedly supported.
Everyone was asked: " 'Is there anyone in this room that has a problem with it? Is there anything else we need to change?' Silence,” Gale said.
“ 'By that, does this mean this is a good measurement tool?' Silence,” he said.
In contrast to remaining silent when asked if there were any problems with or changes needed to the survey's announcement, representatives of the 12 companies were asked specifically, “Does this press release accurately represent your position on this?” Gale said.
“Ten of the 12 immediately said, 'Yeah, we're in.' This is important.” Representatives of two other vendors expressed support, but were less enthusiastic, he said.
The questions will gauge an EHR's capabilities to exchange data across multiple uses cases, including outside organizations not using their own brand of EHR.
Developers will be graded on their EHR's capabilities—e.g., how well it delivers patient information, the completeness of that information and its ease of use.
The survey also will ask providers to select and rank the “greatest overall barriers to interoperability.” Multiple-choice answers include vendor competence, technical barriers and the unwillingness of the survey respondent's organization—or the respondent's competitors—to share information.
That may lead some developers to identify themselves as responsible for data-blocking, an issue that's been front and center on Congress' agenda.
”The government may look at these measurements” from the summit process, Gale said, but whether that will head off legislation remains to be seen.
Just the same, Gale said, they've already notified the ONC and some interested members of Congress about their work.
There's been a lot of finger wagging and blame shifting this year about the lack of interoperability even though three recent surveys sponsored by HHS' Office of the National Coordinator for Health Information Technology indicate health information exchange is widespread and increasing.
KLAS also released two interoperability reports based on a separate survey conducted earlier this year and created in collaboration with the College of Healthcare Information Management Executives, the professional association for hospital CIOs.
In one of the reports Interoperability 2015, Are We Lifting Together? (PDF) KLAS researchers found little evidence of vendors willfully impeding data flows.
KLAS noted that EHR developer Cerner Corp. and other vendors now have “minimal cost barriers” to interoperability or have dropped their fees for data exchange altogether.
Roughly a third of the companies in the 31-member Electronic Health Record Association sent executives to the Utah summit. Ten of the 12 EHR vendors there were EHRA members.
The trade group for EHR developers, an affiliate of the Healthcare Information and Management Systems Society, did not endorse the summit survey process, saying in a statement it supports efforts “to move the industry forward toward measurable interoperability” and “associated measurement efforts.”
The survey will kick off in January and final survey results are expected by summer, although some preliminary numbers may be released before then, Gale said.
*Correction, Oct. 28, 2015:*
This story has been revised to correctly characterize how vendors reacted to the agreement.
