Today we had a really interesting #HITsm chat about interoperability, data hoarding, and sharing healthcare data. Tomorrow we’ll have a post on EMR and EHR that summarizes some of the key tweets from the chat. Although, there was one theme that really struck home to me during the chat.
The biggest barrier to EHR interoperability and data sharing is incentives.
During the chat multiple people including myself made the observation that the reason EHR vendors don’t share data is that there’s no incentive to share data. I can’t say I’ve ever seen a hospital choose to not go with an EHR because it couldn’t interoperate with another EHR vendor. The incentive isn’t there for the hospital and therefore the EHR vendor.
Think about the EHR interoeprability announcement of CommonWell. While the CEO’s of the five EHR vendors can sit there and say that they’re doing it because it’s the right thing to do for healthcare, these public company CEOs also have a legal responsibility to do what’s best for the shareholders of their company.
The reality is that CommonWell would have never happened if there wasn’t an incentive for these companies to put CommonWell together. Rather than beat around the bush, these EHR companies came together to stick it to Epic and to give them a strategic advantage over other companies that can’t or won’t share data. You can certainly make an argument for why doing this is good for healthcare as well, but if there was no outside business incentive to CommonWell then the healthcare benefit wouldn’t have been enough.
As one person tweeted during the Twitter chat, If there were money paid for sharing data, all the fear and issues would suddenly disappear and solutions provided.
When thinking about incentivizing EHR interoperability, Farzad Mostashari’s words at The Breakaway Group event at TEDMED come ringing into my ears, “Incentives and money aren’t always the same.” Cash or otherwise, EHR interoperability needs some incentive.
YES!
Middleware HIT interoperability tools exist today!
The issue addressed in the article is compounded by the active intention to keep the systems incompatible to force clients to ‘choose’ based on lobbying and marketing strength rather than seeking meaningful use within the existing legacy environment.
“I can’t say I’ve ever seen a hospital choose to not go with an EHR because it couldn’t interoperate with another EHR vendor”.
I don’t entirely agree with this statement. I work for a vendor and have clients that chose one product over another because it was the same vendor’s products.
While that doesn’t quite mean choosing a product because it communicates with a different vendor’s, it does say that healthcare organizations sometimes choose one product because it has already purchased another from the same vendor; the ability to exchange data is built in.
Diane,
Interesting observation, but I’d say that there’s a lot more to it in the example you gave. Sure, they might like that all the data is available and they don’t have to do an interface, but I expect that the other reasons for sticking with 1 vendor are more compelling. For example, one company to call for support, one company to pay, one system to support, one system for help desk, etc. The ability to share records is probably much lower on the list of reasons why they chose to stick with 1 vendor.