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January 31, 2018

Let’s talk: building systems that communicate for better health care

Through interoperability, informatics can empower disparate health systems to "talk" to each other—making health records more portable.

As consumers, we demand easy access to electronic data in our everyday activities. We go online, sign in to our Google (or LinkedIn or Facebook) accounts, and instantly connect with people and services from almost anywhere in the world. We expect the data transfer process to be simple and seamless.

What about medical records?

When we think about health data, having our medical records where they can be easily accessed and exchanged by different providers from any location is far more – indeed, critically – important. We need all our doctors to see the full picture of our medical history, wherever we are. These days, a majority of health care providers and nearly all hospitals in the United States use electronic health record (EHR) systems rather than physical paper records. This gives health records more permanence and flexibility—and we saw how important this could be when Hurricane Katrina wiped out thousands of physical health records in New Orleans hospitals back in 2005.

EHRs are big businesses now, and they make their own data structures, systems and applications. Our current ecosystem of EHRs, however, are not interoperable – that is, they don’t “speak” the same language. This creates a communication challenge when people receive their care from providers using different EHR systems. If my internist is running Cerner and my ophthalmologist is running Epic, for example, all my information is not being collected in one place.

Bridging across data silos

With the growing adoption of EHRs has come health information exchanges (HIEs) to fill in the gaps between the various EHR systems. An HIE network will standardize the languages and codes spoken by different EHR systems to allow sharing of critical information. The goal is to bring all the information together so that the patient can have one record and medical history that can be shared and transferred among all their providers, wherever they are located.

We’re now seeing some EHRs becoming their own HIE as well. For example, under Epic, a health care provider can now access a patient’s Epic records across the United States. Going outside the Epic system, however, still requires external HIEs. Beyond HIEs, other trusted networks have also been established to help share key medical information from one provider to another.

On the horizon

“Making the right medical data available at the right time to the right people through interoperable systems is critically important for optimal patient care.”

Another way people are thinking about moving medical data is through personal health records (PHR) that are stored online on the “cloud.” In this approach, patients own their medical data and can choose to share it with any of their doctors by logging into a website where the data are stored. A person’s PHR could include data from several different EHRs. Connecting an individual’s data at the level of their location, rather than a particular provider’s, is the way our social media analytics work. It’s no surprise then, that large technology companies like Apple and Google are looking into providing this service.

PHII and interoperability

Making the right medical data available at the right time to the right people through interoperable systems is critically important for optimal patient care. The U.S. Office of the National Coordinator for Health IT (ONC) is committed to advancing this goal and has established a roadmap to interoperability for healthcare providers by 2024. At PHII, we are supporting this important objective and are partnering with ONC and other organizations to achieve it. Stay tuned for more on this in future blogs!