For Epic, interoperability comes from within

Within the next month, providers using Epic Systems Corp. electronic health records will be able to work with data from a patient's records even if it's from another institution.

Providers will be able to search patient information—including free text—that comes from other organizations, for instance. They'll also be able to book patients directly into other providers' schedules.

"Essentially, the patient is going across the border of two different systems, but to the providers, it works more like one," said Dave Furhmann, vice president of interoperability for Epic, said of the new feature, called One Virtual System Worldwide. "We're moving our interoperability from being able to just view information across systems to being able to do more across systems."

The work incrementally builds on Epic's previous interoperability efforts, which already allow Epic providers to exchange records—they send more than 2.3 million per day—and view patient data from multiple organizations in a single view.

"We're excited about the next logical step, which is workflow interoperability, so you can begin to do transactions across institutions ," said Darren Dworkin, CIO of Cedars-Sinai. "Up until now, most of our focus has been interoperability of information—that is, moving information from one place to another."

Though Dworkin is excited about the new capabilities, he remains pragmatic about interoperability. "We have a long way to go," he said. "It's not going to be magical that when we turn this on, we're done."

In the future, Epic will let providers perform duplicate checks across healthcare systems. The EHR will alert a physician if another health system recently completed an order he or she just placed.

Epic's announcement comes on the heels of a big interoperability push from Apple, which now lets patients from certain institutions aggregate their health records from those institutions in the Health app on their iPhones, regardless of EHR.

Via MyChart, its patient portal, and technology it's calling Happy Together, Epic allows a similar aggregated view to patients whose providers have moved to the latest version of the software. Patients can also use Epic's Share Everywhere tool to show their providers web-based views of their outside records.

"In general, what Epic is doing is good news in that it's an advance in patient care," said John Kelly, principal business adviser for software firm Edifecs. "But the main story needs to continue to be general interoperability across EHR systems, not within them."

Both Apple and Epic are relying on a set of standards, FHIR, that's being pushed by the federal government, including the Office of the National Coordinator for Health Information Technology. FHIR could help the industry reach greater general interoperability, Kelly said, but it's not quite ready yet. "FHIR isn't to the point where we can do nationally what Epic is doing for its customer," he said. A change in payment models could catalyze advances, though. "If there's anything driving sharing information besides patient care," he said, "it's that we have to move to value-based models."