Imagine if your iPhone could only ring other iPhones, but not connect calls or send text messages to Android-based mobile devices. That wouldn't render your phone useless, but its value as a communications tool would be greatly diminished. The telecommunications sector has wisely avoided this situation, designing connectivity systems that bridge technical variations between manufacturers, models and operating systems.
We must do the same for patients. Our recently released report, “Sharing Data, Saving Lives” is a collaborative wake-up call from seven of the nation's leading hospital associations about the critical importance of crossing the finish line to full interoperability of patient health data.
What does this mean? It means an up-to-date, comprehensive electronic health record generated from all sources—from doctors' notes to test results to Fitbit feedback—that are accurately and easily shared between providers. These records equip the care provider, patients and families with the information necessary to make decisions that lead to successful outcomes. The secure exchange of these records is vital to the future of care.
As a nation, we are only partially there. Hospitals and health systems have invested hundreds of billions of dollars and made much progress in recent years toward achieving full interoperability of health information. For example, 93% of hospitals nationally give patients the ability to view their health records online, up from 27% in 2012. And 88% of hospitals now send records to ambulatory-care providers outside their system, up from 37% in 2012. This validates the significant expansion of patient-friendly portals created and supported by care providers.
Despite this commendable progress, our system of sharing, securing and transferring complete patient health data is still limited in many cases by differing vendor platforms, geographic region, inconsistent use of standards and other factors. As a result, health records and data that would provide a more complete picture of an individual patient's health can be garbled in transmission or remain bottled up at the source.
In our call to action, we urge all public and private stakeholders to redouble our efforts to complete a national system of interoperable health data.
What will it take? We offer six pathways to advance a system that works for all:
- Security and privacy. Stakeholders must be able to trust that shared data is accurate, secure and used in accordance with best practices and patient expectations.
- Efficient, usable solutions. Data must be available where and when it is needed and in a useful format.
- Enhanced infrastructure. The infrastructure to connect information-sharing networks will require consistent use of standards, semantics and a common set of “rules of the road” for exchange.
- Standards that work. Connected systems require standards implemented to minimize proprietary solutions and gatekeeping.
- Beyond EHRs. Interoperable systems must expand to include population health, the social determinants of health and patient-generated data.
- Best practices. All stakeholders should exchange best practices so we can continue to build on what works.
These approaches will help to overcome the remaining hurdles blocking interoperability efforts underway across the nation. One example highlighted in our report: HCA Healthcare has automated a process for closing the surgical referral loop. A surgeon referring a patient to an HCA hospital sends the relevant patient records in advance of admission. Upon patient discharge, HCA automatically sends updated information back to the referring surgeon, who can provide informed follow-up care.
There are many similar examples of innovative thinking and problem-solving in action. Hospitals and health systems have done the best they can using the tools available to them, but we need more.
Achieving full interoperability will benefit the entire healthcare system. It will lead to strengthened care coordination; improved safety and quality; empowered patients and families; and increased efficiency and reduced costs. We've come far and the finish line is in sight. Let's cross over.