The healthcare industry has infamously struggled with disconnected data systems and a lack of interoperability. When health information cannot be easily exchanged between different systems and providers, it leads to fragmented care, medical errors and delays in treatment — not to mention an incredible amount of frustration and inconvenience for both providers and patients.
Software developers have been working hard in recent years to create tools and data sharing standards that foster a more cohesive and integrated approach. However, these tools have a serious adoption problem, experts said last week during a virtual panel held by Reuters Events.
Alistair Erskine, Emory Healthcare’s chief information and digital officer, pointed out that most provider referrals are still done by fax, even though there are tools available to send them digitally. Most providers use EHRs that are able to pull a patient’s health information and transport it to the EHR of the new provider to whom they’ve been referred, he said.
Despite data sharing standards like FHIR and DICOM — and despite “the fact that the data has already been digitized” — completing a provider referral is still not a smooth process, Erskine remarked. He stated that 98% of referrals are done by fax even though they could “of course” be done electronically.
“Even though the standards are there, we have to make sure that people safely log into their systems, and we have to make sure that people are able to find their patient in their systems. And if you navigate from one system to the next, that presents a barrier to entry. It’s easier to just take a piece of paper, write what you need and send it in a fax,” Erskine explained.
Healthcare leaders shouldn’t assume that providers are using interoperability tools simply because these tools are available, he declared.
That’s why Emory is trying to make it as easy as possible for providers to conduct referrals electronically, Erskine remarked. He said the health system is embedding links into its systems for single sign-on and in-context patient lookups so that “providers don’t have to log into anything” and can quickly find their patients’ information. He also mentioned that Emory is testing ways to use direct messaging to connect doctors across systems.
Another panelist — Micky Tripathi, head of The Office of the National Coordinator for Health Information Technology (ONC) — agreed with Erskine’s remarks.
“When it’s easier to fax something, people will continue to fax things. There are adoption issues,” Tripathi stated.
He described a recent experience he had with his mother to illustrate the healthcare industry’s interoperability adoption problem. His mother had recently undergone a medical procedure in an acute care hospital and was getting transferred to a rehabilitation hospital “less than a mile” down the road, he noted.
Tripathi said that he knows these two hospitals exchange patients “all the time.” He also said that he knew one hospital operates on Epic’s EHR, and the other on Cerner’s.
“I know they’re connected on the back end with an interoperability network called Carequality. I know they are for a fact. And yet, when they discharged my mom, they printed off the record and handed it to me,” Tripathi declared.
This shows that healthcare workers don’t find it easy to transfer patients’ information electronically, he pointed out.
In Tripathi’s view, health systems and other provider organizations should do more to encourage their doctors to stop faxing — both by training staff on how to use electronic referral tools and making these tools easy to use within the EHR.
Photo: LeoWolfert, Getty Images