Electronic health record vendors athenahealth and Epic tied for first place with the highest interoperability scores in a survey of nearly 250 providers across inpatient and ambulatory settings.

Vendor research firm KLAS Enterprises and the College of Healthcare Information Management Executives conducted the survey to gauge provider views on the interoperability strengths and weaknesses of EHR vendors.

“My biggest surprise was how strong athenahealth is on the interoperability side,” says Adam Gale, president of KLAS. “Maybe I expected that more from Epic. But, Epic obviously connects with their own customers in an incredible way.”

Study participants indicated that athenahealth is the easiest vendor to connect to, followed by Cerner and Epic. While providers rating their own vendors picked athenahealth and Epic as easiest to connect to, when connecting with “foreign” EHRs, the survey revealed that providers see athenahealth and Cerner as leaders in connection ease. The only major weakness attributed to athenahealth was that its “athena-to-athena sharing ability could be stronger.”

What also interested Gale was how providers perceive Epic. “It’s fascinating that the perception of Epic is they’re the toughest to work with, unless you’ve actually worked with them.”

According to the KLAS study, 44 percent of providers with no or very limited Epic experience report a perception that Epic struggles the most with interoperability. “Contrary to this perception, Epic customers, providers connecting into Epic, and even other vendors give Epic high marks for interoperability strengths,” states the report.

When questioned about the prevalence of information blocking, 98 percent of providers indicated they are willing to share data while only 82 percent report their main competitor to be similarly willing. KLAS finds that smaller ambulatory practices are the least likely providers to want to share their own records. At the same time, the firm notes in its study that “no provider reported a circumstance in which a vendor contractually or otherwise willingly impeded information sharing, aside from the business models around profitability” and that providers “overwhelmingly report their vendors to be willing to help them share but say business revenue models and lack of technical resources often get in the way.”

Gale says he “chuckles” at the notion of information blocking on the part of EHR vendors. “We work with a lot of these vendors and I just don’t see it,” he remarks. “If charging to set up interfaces and integration is information blocking, then every vendor does it. Every vendor charges one way or another for this.”

Standards, Metrics

Both providers and vendors point to standards as the main barrier to interoperability, according to the study, and both segments view Health Level Seven’s emerging FHIR interoperability software as the standard that “will be of highest future value, while prominent collaborationsCommonWell and The Sequoia Project (also known as Carequality or Healtheway) areconsidered by providers as significantly less likely to improve future interoperability,” according to KLAS.

Earlier this month, executives from 12 EHR vendors met at a summit convened by KLAS and agreed to develop interoperability metrics that participants are calling Consumer Reports-like in their design and the first of their kind for the healthcare industry. The KLAS Keystone Summit held in Midway, Utah, included not only the vendor execs but provider CIOs as well, who agreed by consensus to the measures of interoperability and ongoing reporting.

Also See: EHR Vendors Agree to Uniform Interoperability Metrics

“It was almost a miracle,” exclaims Gale regarding the preparations for the summit. “It felt like a junior high school party of ‘who’s going to be there? And, if so and so is not there, then I’m not coming.’ People were also nervous about what was going to be said about them. But, in the end, almost everyone showed up. It was a great discussion. They were all very civil. And, hopefully, we actually have an agreement on a measurement—which we seem to—and when it is actually done we’ll see if they’re still smiling about it.”

The vendors adopted a standard interoperability measurement tool developed by John Halamka, M.D., Chief Information Officer of Beth Israel Deaconess Medical Center, Stan Huff, M.D., Chief Medical Informatics Officer at Intermountain Healthcare, Daniel Nigrin, M.D., Chief Information Officer at Boston Children’s Hospital, and Micky Tripathi, President and CEO of the Massachusetts eHealth Collaborative.

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