Interoperability a Key to Effective Communication
When implementing a new electronic health record (EHR) system or updating an existing one, interoperability will be a key for success in efficiency and quality in your health care system.
Connectivity is essential to successful adaptation of market- and regulation-driven health reform. The implementation of ICD-10, incentives tied to meaningful use, and revenue enhancement realized through new technology means practice managers must look forward. A key component of the Health Information Technology for Economic and Clinical Health (HITECH) Act is to improve the quality, safety, and efficiency of care while reducing disparities. An important part of this objective is achieved via computerized physician order entry (CPOE) systems. These systems include patient prescriptions, diagnostic radiology workups, and lab test orders with returned results. In addition, communication between different providers and facilities will be necessary to facilitate quality and reduce disparity across the continuum of a patient’s care.
For example, a number of large labs have deployed Web-based portals enabling physicians to place lab orders and receive test results electronically. These systems are more efficient than paper, but less efficient than a lab order system that is fully integrated with a practice’s EHR. In comparison, a practice with an EHR that communicates directly with a lab enables a provider to order a lab while completing the patient’s chart; the order is communicated to the lab, and the results from the lab are fed back into the EHR for the provider to review. This process eliminates additional data entry, resulting in more efficient staff and fewer opportunities for error.
The advent of accountable care organizations (ACOs) and medical homes set new targets for physician offices which, to remain competitive, are forced to consider participation. Interoperability is essential for success. Disparate computer systems must communicate structured data in a way that both systems understand. Consistent meaning in information systems is vital to protect a patient’s quality of care. Uniform values, variables, data dictionaries, and vocabularies are necessary to avoid errors occurring with subjective information.
Factors making interoperability difficult include computer systems using varying “vocabularies” (eg, terminologies or nomenclatures), which are systems of codes used to communicate a specific meaning. There are several hundred vocabularies in use. EHR vendors use proprietary vocabularies, but now the emphasis is on interoperability, making EHRs central to a sustainable information infrastructure, which requires standards.
As practices consider financial and resource investments in information technology such as EHRs, consider the level of interoperability available in your new system now and what your vendor is preparing for in the future.