Uptake of Integrated Electronic Health Records Remains Slow

Electronic health record adoption is high, but integrated records pose a challenge.

While healthcare becomes more technology-based and data-focused, different stakeholders must keep up to date with emerging trends to ensure that their patients are receiving the most streamlined care.

Hospitals may be behind the curve in ensuring that providers have access to complete electronic health records (EHR) when patients are receiving care from other providers, according to a study published by Health Affairs.

In 2014, 24.5% of hospitals achieved interoperability, which is the degree that data from other providers is accessible and integrated, according to the authors. The study showed that in 2015, 29.7% of US hospitals had achieved proficiency on measures of interoperability, only a slight increase from the previous year.

“I would have thought we’d see more movement in these measures, because electronic health records have been widely adopted for several years,” said senior author Julia Adler-Milstein, PhD.

Included in the study were data from 2363 hospitals participating in the IT Supplement survey conducted by the American Hospital Association (AHA) in 2014 and 2015. The study also included a sample of 3538 hospitals that participated in the 2015 IT Supplement survey, which showed that only 18.7% of hospitals used patient data from outside sources frequently.

The Health Information Technology for Economic and Clinical Health Act of 2009 granted $30 billion to help hospitals and ambulatory providers adopt EHRs, according to the authors. The Office of the National Coordinator for Health Information Technology (ONC) has a goal of achieving widespread interoperability by next year.

The authors report that the slow progress towards widespread interoperability calls into question whether hospitals will meet the ONC’s goal by 2018, according to the study.

The study also uncovered several barriers to integrated EHRs, including information overload for clinicians who must account for several sources of data. This factor is likely why hospital adoption of integrated EHRs is lagging, according to the study.

The authors found that hospitals have focused mainly on moving EHRs from one institute to another instead of integrating subsets of data that would help inform clinicians.

“At the most fundamental level, interoperability and clinician use of outside records is about whether your doctor has access to the information she needs,” Dr Adler-Milstein said. “So, when we know that less than half of hospitals can do that, it’s terrifying.”

When the authors examined data from the 2015 study, 43% of hospitals reported that outside information was available when needed, but one-third rarely or never used it, according to the study. A common barrier preventing this was that providers could not see the information in their own EHR system.

However, the study discovered several positive areas that demonstrate novel ways of providing patient care. The authors found that the patient-centered medical home model was linked to hospitals using outside EHRs, according to the study. This model encourages the use of primary care and harnesses patient data to manage health at the population level, according to the authors.

The authors concluded that for further progress to be made, hospitals must continue to improve and integrate their EHRs.