Interoperability is no longer the missing link in electronic health information technology, but the chains binding hospitals, physicians and patients are still incomplete, according to three surveys released this month by federal researchers.
Office of the National Coordinator for Health Information Technology at HHS report results for data exchange in both hospital based and outpatient based medical practices and report increases in data exchanges that are considered measures of interoperability.
Largely attributable to Meaningful Use 2, 91% of reporting hospitals report availability of a patient engagement portal but no mention made of percentage of hospital patients that utilize the patient. Over half of physicians exchanged secure messages with patients which is approximately double the rate of physicians that have attested for MU2.
It appears that medical entities are responding according to the regulatory requirements and overall best business interests. If MU 2 calls for patient portals hospitals quickly developed them. MU2 attestation by Independent physicians is low so not surprisingly, the implementation and utilization of patient portals is much lower.
ONC reported that “transmitting a record from a hospital’s EHR to another provider’s EHR or a patient’s device was the least available function, with two out of three hospitals having that technology”.
“Types of information exchanged in 2014 were fairly uniform, with 34% sharing lab results and medication lists, 33% exchanging medication allergy lists and problem lists, and 32% exchanging imaging reports. But fewer than one in 10 physicians exchanged all five types of information, the study reports.”
Not surprising the information collected in format for MU program would be the content most readily shared between partners. If you are paid to do so, you will likely document that you are interoperable for the information share being measured.
It is apparent from the ONC reports that reporting medical entities are showing increasing transactions of the type and method for which Meaningful Use and the ONC are providing financial incentive (or withholding penalty for noncompliance). In some cases, reporting that a method is available does not provide any information about how commonly it is utilized or if the method of conveyable is even readable by the recipient. It would equivalent to a payor getting credit for sending payment even though the payee did not receive the check or cannot cash the check.
Most of the MU program and the ONC interoperability metrics are transactional and not interaction based metrics. Measurements of capability to convey information is not related to how effectively this information is delivered to the party that needs to receive the information or in a format that is consumable or in a time frame that enhances the patient care.
Meaningful Collaboration(SM) is more than just collecting selected data fields to document Meaningful Use just as interoperability is more than having capability of transmitting information. A better question might be: how often do you collaborate with another medical provider in another information system using electronic means and produce an alteration in the treatment plan or patient outcome.
In future BLOGS we will discuss some of the reasons by Meaningful Collaboration(SM) is a more clinically useful metric.