Interoperability in healthcare was foremost on many conference goers' minds after a landmark health information exchange announcement. Read part two of this two-part series
to learn what HIMSS attendees had to say about the roles vendors and providers must play in order to facilitate future exchange of healthcare data.
With no significant federal policy announcements at HIMSS 2013, the issue of interoperability in healthcare received top billing. Cerner Corp. and McKesson Corp. made headlines when they announced CommonWell Health Alliance, a nonprofit group whose aim is to create cross-vendor standards. And National Coordinator for Health IT Farzad Mostashari, M.D., continued to push for more information exchange in his speeches.
One of the difficulties is that you've got so many stakeholders with so many motivations. It's a weird software market. Providers are very diverse. It's been very difficult to make something work for everyone. It's inherently messy.
outreach and marketing director, Certification Commission for Health Information Technology
HIMSS 2013 attendees who work on the issues of interoperability and information exchange were generally pleased the topics had such a high profile at the event, but many still feel that progress toward achieving data liquidity remains frustratingly slow.
"One of the difficulties is that you've got so many stakeholders with so many motivations," said Sue Reber, outreach and marketing director of the Certification Commission for Health Information Technology (CCHIT), which certifies EHR software for meaningful use readiness and interoperability. "It's a weird software market. Providers are very diverse. It's been very difficult to make something work for everyone. It's inherently messy."
Providers have a large role to play in driving interoperability
For Reber, the lack of interoperability in the health system is a problem that all stakeholders will need to solve. Many people look to vendors for not making it easy enough to extract data from their systems and into competitors' software, but providers have a role to play in improving interoperability as well.
She pointed out there can be different ways of implementing defined standards. If one provider has one interpretation and a trading partner has another, it doesn't matter if they're using the same standards; their systems will not be able to communicate with each other.
Providers also need to consider the IT ecosystem in which their business partners operate. Michelle Knighton, health care testing manager at ICSA Labs, a software testing and certification company, said an EHR system may be certified as being interoperable with a specific set of other products. But if a provider wants to report data to a public health entity or share information with an affiliate who uses a system not on that specified set, the product will not be interoperable in their practice. Providers need to think about this before purchasing systems.
"It's really important that they do some due diligence before selecting systems," Knighton said.
She added that users are going to be the main drivers behind any progress made toward interoperability in the coming years. If providers stand up and ask for systems that can communicate with other vendors' software tech companies will follow by offering products with this functionality. Knighton said she hopes IT purchasers will continue to educate themselves on the options they have available before making any vendor decisions.
Responsibility for interoperability remains on vendors
Mostashari has been calling for vendors to support interoperability standards for months now. Some HIMSS 2013 attendees feel that the CommonWell collaboration is a significant step toward this, but not everyone agrees that the project will deliver true industry-wide standards.
David Caldwell, executive vice president at San Jose, Calif.-based Certify Data Systems, which works with providers on interoperability issues, said he believes CommonWell is a method for the vendors involved to take on Epic Systems Inc. -- the market leader in EHR implementations -- and is skeptical it will lead to greater data liquidity. He said this fits with a pattern he sees among EHR vendors that talk a great deal about interoperability but then lock down users' data for proprietary reasons.
"I am just appalled at how the suppliers talk about sharing, but at the end of the day they just don't do it," Caldwell said. "There is a lot of misinformation out there. It is kind of sad that they tell the market one thing and then can't deliver."
Caldwell said he thinks the sheer number of certified EHR vendors is one problem holding interoperability back. Providers looking to attest to meaningful use currently have hundreds of options. It would be difficult to get that many different vendors to rally around one set of standards.