A few months ago, I was having a conversation with a vendor executive about the challenges EMR companies face. He said that in his mind, the big differentiator won’t be interfaces or even key features, but the extent to which the vendor has hooked up with key outside services.
According to this man — whose story, to be honest, I haven’t been able to verify — it can three months or more to link up with big laboratory providers like LabCorp or Quest. Partnering with payors is another nightmare, even for vendors that run a practice management system already handling billing issues. And what about synching up with radiology information systems
Now, don’t get me wrong: Service providers are getting wise to this problem. LabCorp, for example, now boasts about its EDI interface and touts its connections with 300+ EMR, practice management and laboratory information service vendors. It also offers eLabCorp, a Web-based solution for test ordering and test result retrieval.
Private software vendors are also in the mix. For example, I stumbled across one vendor offering bundles that connecting physicians, payors and radiology information systems.
But most of the interface development seems to be ad-hoc, with the costs borne by the healthcare provider rather than the EMR vendor. And it’s a costly problem.
As things stand, after all, creating flexible, functional interfaces between EMRs and key service providers is still largely a job for specialized experts, and they don’t come cheap. (As readers know, it’s not that your crack IT team can’t build the interfaces on its own, but where will staffers find the time?)
However, my guess is that as IT users get their bearings, they’ll demand a better range of connected partners from EMR vendors. Rating how connected vendors are to labs, payors and other transaction partners is likely to rise close to the top of RFPs and internal checklists.
Ultimately, even high-end EMR systems will begin to look similar as the hospital industry standardizes on Meaningful Use-driven features and functions. (You’d think a multi-million dollar system would have a unique footprint, but let’s face it, anything can get commoditized.)
Soon, to get hospital business, they’ll have to offer options which directly improve operations or generate profits. And it’s not a moment too soon.
You are completely correct. This gap means a physician office gets a fax of a lab result rather than the result feeding directly into a patient’s record. Huge barrier to use and a safety risk that the result is missed.
A large EMR vendor in the midwest typically charges $60,000 to build one interface – for a provider who uses services at a couple labs and two or three hospitals this just won’t happen.
One of the biggest barriers is the lack of agreement on standards to even send the data back and forth. On this topic, healthcare is 50 years behind the rest of industry.
Joe, interesting to read that $60K number — that just backs up the article’s point. Good data, thanks.
Do you see any hope of standardizing data exchange even within the next 10 years?
Also, do you have any thoughts or knowledge of why banks (hypercompetitive organizations themselves) managed to pull this off? My sense is that it’s because very strong intermediaries emerged, but I’m no banking expert.
The is an effort in California led by CHeQ and CalHIPSO (the HIE and REC groups) to define bundles of standard HL7 interfaces. The effort is called HIE Ready. While the main focus is on ambulatory EHR connectivity, it also deals with interfaces with hospital, lab and connectivity to intermediaries such as HIE organizations. They key is to define the standard components of a deliverable functional kit of interfaces and to put some price and feature transparency into the process of buying an EHR.
All too often a clinic learns of the cost and time to deliver only AFTER they made their EHR selection. It is not unusual to find that a good level of connectivity will cost significantly more than the cost of the EHR itself.
While Direct will address some of the data exchange needs there will still be a huge hole that can only be filled by HL7 v2.x interfaces.