Unintended consequences of EHR regs hinder interoperability

The Electronic Health Records Meaningful Use program pushed hospitals and physician practices to improve care coordination via information exchange to increase data interoperability across the industry.

Now the push is on to bring ancillary providers into the fold, including those in the long-term care, home care and hospice environments, among others, says Kathleen Sheehan, program director of the acute care division and meaningful use at Universal Health Services, a major hospital management company.

At a session during HIMSS17, Sheehan will explain the interoperability challenges facing sub-acute providers, vendors and patients, as well as ways to overcome barriers.

There are unintended consequences of the meaningful use program that other providers now moving toward increased data exchange will face, Sheehan notes. For instance, providers in meaningful use needed to offer a patient portal to give patients access to their data.

But what if a patient has a primary care physician and three separate specialists, and each provider—and the local hospital—has a patient portal? The PCP could advise a patient that a portal is available and encourage its use, as could the hospital and each of the three specialists, so the patient is left with partial health histories in multiple patient portals. Each portal, for instance, could have a partial list of the patient’s lab results, and in all likelihood, none of the portals will have a complete list.

So not only could patients face new difficulties in getting and organizing their health data, but so do their providers. And the information in all those portals are all formatted differently, making it even more difficult to find information.

Sheehan will give real-life examples of data being exchanged and some of the challenges that can arise because of how a particular EHR is configured. A provider asking another provider for recent vital signs of a patient may get 40 pages with every single vital sign and expired medication since 2009. Or, someone asking for a problem list might get 30 pages of problem lists. Uniformity, she will tell attendees, is still a ways off. Following Sheehan’s presentation, Sindhu Kammath, MD, a clinical informaticist at Universal Health Services, will aid in answering questions from the audience.

Session 86, “Overcome Challenges/Obstacles to Achieving Interoperability,” is scheduled at 10 a.m. on Tuesday, February 21 in Room 311A.

For reprint and licensing requests for this article, click here.