The challenge of exchanging information among health care providers goes far beyond programming. Certainly, EHRs that use differing formats and structures increase the task of meaningful and necessary clinical data communication, but needs reach far beyond simply technology issues. Strategic priorities must be established and aligned in order for delivery of patient care to improve and the transition toward value based care to be accomplished effectively. The struggle to provide access to data is real and one that we talk to people about every day. Most patients, and even many doctors, assume all pertinent data is available to anyone who should be granted access. This is simply not the case in most communities.
Public health information exchanges have attacked some of the problems, providing a public utility of sorts to manage the flow of information. And private HIEs close gaps for some institutions, especially following mergers and acquisitions of practices and health systems, but integral to the process of interoperability is stakeholders achieving alignment with goals, plans and initiatives.
In order to ensure the right data is presented to the right people at the right time, and the creation of a truly integrated EHR is available, a course of action can include multiple tools, APIs, options and approaches. For some systems, a single EHR can be used including add-on modules to incorporate data. In other situations, such as when legacy data is required to be accessible from retired EHRs or when many data sources are using a variety of different systems, custom built or customizable off-the-shelf interface engines might be the best choice.
Decisions abound but one thing holds fast — tackling interoperability strategy shouldn’t be done in a vacuum. Using objective strategic advisors to collect requirements, assess cultural implications, evaluate vendor offerings and help to plan the most effective and efficient path will save costs, headaches, and, in the end, lives through the improvement in patient safety and care quality.