EMR Interoperability is the ability to effectively communicate health information electronically. There are two fundamental components. The first is the ability to securely transport the data and the second is the ability to interpret and use that data. Stage 2 Meaningful Use sets requirements that help move Health IT towards interoperability.
The mechanism for standardizing the transportation component of interoperability is the Direct Project under the Office of National Coordinators (ONC) Standards and Interoperability. This new specification will become the new “fax machine” that will carry the information to its recipient. The Consolidated Clinical Document Architecture (CCDA) will standardize the structure of the clinical summary.
There are many reasons for sharing information between the various providers of the patients’ health care. A patient may need to see a specialist at a different practice, have test results sent from a lab, or they may have a medical emergency requiring a trip to the ER. Interoperability will allow care facilities to share the patient’s records in real time without compromising patient security or privacy. Providers, patients and insurers all benefit from increased access to the patient’s medical information.
While interoperability may be an afterthought when selecting an EMR, it should be in the forefront of the provider or practice manager’s thoughts. Interoperability is an essential part of the government’s Meaningful Use Stage 2 requirements, which begin to take effect at the end of the year. Meaningful Use Stage 2 will affect Medicare payouts for health care providers in stages, eventually leading to reduced payouts to all providers that take Medicare and do not follow the guidelines.
When using an EMR, a provider can receives the patient’s data in real time. This allows the physician to make informed decisions about the patient’s health without waiting on paper records, faxed/scanned information or requiring security clearance on other providers’ systems. When another facility requests the patient’s records, there’s no need for the practice to waste resources sending the data since it’s all done electronically.
The information is available immediately in a searchable form that eliminates hunting through complex charts or deciphering illegible handwriting. This reduces the risk of malpractice lawsuits that stem from misreading data and wrong diagnosis due to physicians not having the information they need.
Interoperability allows a patient’s medical records to follow them throughout the health care system. Patients benefit from increased access to their medical records, faster communication and better quality of care. A patient could visit the doctor, submit samples for testing and view the test results on their computer or mobile device, all in the same day.
This speedy transfer of information has a real impact on the patient’s health, as many conditions require immediate intervention to save the patient’s life or minimize long-term effects on their health. For example, if a patient has a stroke or heart attack in the middle of the night, the physicians on duty at the emergency room have instant access to the relevant data in the patient’s medical records such as their list of medications, allergies and other important information.
While there is debate on how much money EMR adoption and interoperability will ultimately reduce the cost of healthcare, some studies point to a reduction of up to $100 billion per year. The primary cost savings stem from reducing malpractice lawsuits, hospital stays and patient visits, and eliminating redundant or inapplicable testing and unnecessary procedures.
In the past, some health care providers viewed patient data as their property, unable or unwilling to share data with other providers outside their organizations. Today these barriers are coming down with benefits of all parties involved.
The Open Source movement is proving to be a driver force in the development and implementation of interoperability. The open source community is working in collaborative ways and will help remove the health information silos that have been in place by proprietary software and large commercial vendors.
OpenEMR, the Open Source project, has worked closely with the Direct Project. The code to integrate with the Direct Project is a part of the OpenEMR code that can be freely downloaded.
ZH OpenEMR, a cloud based version of OpenEMR, is currently conducting a pilot project with a Health Information Exchange (HIE) in addition to establishing connectivity to labs, prescription networks and immunization registries via this mechanism.