EHR Integration
Health information blocking and vendors’ unwillingness to share data has halted EHR integration and limited the advancement of healthcare information sharing.

Despite being a field that regularly produces advances in treatment, healthcare in some ways remains behind the curve in terms of sharing data.

Case in point: Electronic Health Records, or EHR, is “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting,” according to the Healthcare Information and Management Systems Society (HIMSS). EHR may include patient demographics, progress notes, medications, past medical history and immunizations, among other things.

It sounds like pretty basic stuff, considering supermarkets are able to track your favorite brand of peanut butter or measure how often you buy cat food.

However, healthcare organizations and providers have had difficulties sharing information, according to an April 12, 2016 article by EHRIntelligence.com, which noted that the main reason why is not what many assume.

Technology is not to blame

“One misconception surrounding EHR integration efforts is that the larger issues are technical in nature, when, in fact, they’re actually related to information architecture and workflows,” Arcadia Healthcare Solutions CTO Jon Cook told EHRIntelligence.com. “For a long time in the technical field, we’ve known how to exchange data. The challenge lies in whether or not the EHR vendor will permit the exchange of data and, if so, if the data is in a format that the receiver is able to understand and use.”

Many vendors are unwilling to share information, a process called health information blocking.

The Office of the National Coordinator for Health Information Technology (ONC) reported to Congress in 2015 and 2016 about the problem. It concluded that congressional intervention might be required to end the practice.


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“Many types of information blocking are beyond the reach of current federal law and programs to address. Thus, a comprehensive approach will require overcoming significant gaps in current knowledge, programs and authorities that limit the ability of ONC and other federal agencies to effectively target, deter and remedy this conduct,” the 2015 report said.

The ONC said most blocking doesn’t occur because of “knowing and unreasonable interference.” That said, it did note practices it deemed as unreasonable justifications for blocking information, according to HealthIT Interoperability. Those include things such as charging prices or fees that make exchanging information cost prohibitive, as well as contract terms, policies or practices that restrict access to electronic health information.

There also are some other challenges tied to integrating EHR use, according to CSC, a technology company that provides business services. Those include physician practices that can’t (or won’t) implement EHR systems without financial help, as well as smaller practices that don’t have the staff or expertise to operate an EHR system.

Improvement occurring?

A practice called “Meaningful Use,” which was specified in the American Recovery and Reinvestment Act of 2009 has helped spur improvements. It calls for using EHR in a meaningful manner and to use the exchange of health information to improve healthcare quality, according to the federal Health Resources and Services Administration (HRSA).

“Whether you love it or you hate it, Meaningful Use has shined a spotlight on integration issues. As health IT standards progress, we’ve seen vendors becoming much more willing to participate in the open exchange of data,” Cook told EHRIntelligence.com.