The Wrestle to Make Interoperability and External Data More Meaningful

In 2022, KLAS hosted an interoperability summit to determine with leaders across the healthcare industry how to measure vendors’ interoperability performance in a holistic way. After creating a framework—which measures adoption, connectivity, utility, use cases, and outcomes—KLAS surveyed provider organizations that vendors identified as their deepest adopters of interoperability to understand their experience and the possibilities with interoperability. We recently published our findings in our Ambulatory and Enterprise EMR Interoperability report, which reveals that although worthwhile progress has been made, the industry still has work to do.

The State of Interoperability among Deep Adopters

Every vendor has strengths and weaknesses when it comes to interoperability, and we wanted to highlight those in this report. One positive thing we saw is that the number of vendors offering connections (e.g., to national patient record exchanges, HIEs, national payers) is increasing, even among vendors who have historically done little to make certain connections available automatically. Similarly, there is an increasing number of organizations wanting to connect and access external data. The healthcare industry is more connected now than ever, and there are lots of ways to share data. However, connection is only the first step in the journey to sharing meaningful data. Beyond that, it’s important to examine whether the established connections are helpful and impacting care in meaningful ways. This is where progress has been slower.

A main takeaway from this report is that even though we spoke with deep adopters—the cream of the crop, so to speak—several vendors are still being given F grades in some areas, and the highest overall grades are in the B range. Although organizations are experiencing better connections, there hasn’t been as much progress with making the external data useful.

Fortunately, some vendors (i.e., Epic, Oracle Health [Cerner], NextGen Healthcare) have tried to facilitate provider workflows so that external data is incorporated and used efficiently. For example, patient-matching tools can suggest where data should go but ultimately allow users to confirm whether the data has been assigned to the right patient and what data is most relevant. Oracle Health (Cerner) in particular is trying to route correct data into the patient record and save it as an addendum to the official record. Ongoing innovation like this is needed, and we are excited to measure its impact moving forward.

Still, there are several roadblocks to achieving the ideal state of interoperability. Some vendors—like eClinicalWorks, Greenway Health, and MEDITECH—haven’t made as much progress in solving provider workflow challenges. For any vendor, making external data usable at the point of care is a tremendous lift, and it is difficult for provider organizations to make external data a regular part of how they deliver care. It’s fair to say that the industry is grappling with the initial challenges of achieving meaningful interoperability.

Surprises in the Data

Overall, we were surprised that vendors didn’t score higher, since this data comes from deep adopters. Instead, we found that customers still report challenges—no one has achieved interoperability nirvana yet. However, we were pleased that several respondents reported fewer duplicate tests. We didn’t expect that outcome to be mentioned as much as it was; for four different vendors, at least 40% of their customer respondents reported decreased duplicate tests. Decreased duplicate tests can definitely lead to a financial return for some organizations, even though someone still has to be paid to double-check that the test data is accurate. We saw this result as a win for the industry overall.

Future Progress Will Be Gradual

The interoperability market will continue to progress, albeit slowly. Although we’ve highlighted the fact that organizations and vendors are establishing connections, it’s important to remember that there are numerous healthcare organizations that aren’t yet utilizing interoperability. These organizations are the low-hanging fruit that need to be connected next.

Additionally, faxing is still extremely pervasive in healthcare, even among organizations that have established connections. After getting connected, it’s important that organizations think about how to refine data sharing and move away from manual processes. Deeper adoption will expand as external data becomes more useful at the point of care.

As we look to the future, it will be interesting to see how many of the challenges around CCD sharing will end up being addressed by the Trusted Exchange Framework and Common Agreement (TEFCA), which is intended to help enable nationwide exchange of electronic health information across disparate health information networks. TEFCA is still new, but we’re interested to see how it affects organizations going forward.

Call to Action

We at KLAS encourage provider organizations to adopt their vendors’ offerings around interoperability and to seek to share data. Although the challenges and learning curve can be frustrating, effective data sharing can open up so many possibilities for healthcare. Push vendors to support interoperability; this expectation will keep up the pressure and prompt vendors to be better. And, of course, we at KLAS will keep using our reports to shine a spotlight on vendors’ performance and help them improve.

Read further insights in the Ambulatory and Enterprise EMR Interoperability report.

Photo credit: DC Studio, Adobe Stock