Lack of Interoperability Biggest Obstacle for EMRs

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2011 Health Care IT Survey

The race is on for hospitals nationwide to deploy EMRs.

When the federal government took on the push toward electronic medical records, those tasked with coordinating the efforts said interoperability would be the key to making it work. Nearly three years ago, Dr. John Halamka, then chairman of the Health Information Technology Standards Panel (HITSP), told me:

It will take two to three years before the vendors and people acquiring e-health records systems have systems that are totally interoperable and standards based.

Since then, laws have been passed and regulations are in place to award hospitals and other health care providers that adopt electronic medical records systems federal incentive dollars for doing so. The Office of the National Coordiator for Health Information Technology has worked toward establishing standards for interoperability. Yet interoperability is still the biggest obstacle to widespread adoption of e-health records. Why?


Rick Kneipper, co-founder and chief strategy officer for Anthelio Healthcare, told me it's a competition thing.

[T]here's not enough emphasis on interoperability. You might get one hospital's EMR system to talk within itself, but it can't talk to anyone else's EMR system. All the EMR applications are very proprietary and they are purposely designed to not play well with others. ... If you're selling a comprehensive EMR application and you think you can talk that hospital into buying yours, you really don't want to encourage them to keep what they've got and buy yours in addition. You'd rather they rip everything out and replace it with yours.

What's more, Kneipper said, EMR vendors are going to continue arguing against interoperability until the government specifically says, "You can't have [HITECH Act] meaningful use money unless your solutions are interoperable today." The government hasn't done that yet, but it has recognized that the marketplace is not responding to the need for interoperability as quickly as it would like. The ONC's Federal Health Information Technology Strategic Plan acknowledges that interoperability is critical.


And until the market decides to play along, the government's DIRECT system (free, downloadable secure email software) will provide a cheap and easy means by which health information can be exchanged.