Use of electronics health records (EHRs) is important in achieving coordinated care that leads to a better patient experience. While U.S. government initiatives have helped widen EHR adoption — the percentage of U.S. hospitals using EHRs shot up from 9.4 to 75.5 percent between 2008 and 2014 — the lack of system integration has hampered care coordination between healthcare providers, according to an article in

Instead of ushering in a new era of secure and easily accessible medical files, the article notes, EHR vendors (Epic, Cerner, Meditech, etc.) have helped create a fragmented system that leaves doctors unable to exchange information across practices or hospitals. That hurts patients who can't be assured that their records — drug allergies, test results, x-rays — will be available to the doctors who need to see them.

See also: Demand for Digital Connection    

In January 2009, President Obama announced a stimulus plan for digitising the country's medical records. "Within five years, all of America's medical records are computerised," he said. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests." At the time, only 17 percent of doctors in the U.S. stored information digitally.

When Congress passed the $840 billion stimulus package, it allotted $30 billion for hospitals and medical providers to digitise their records via the Health Information Technology for Economic and Clinical Health (HITECH) Act. So far, the government has spent more than $28 billion to doctors and hospitals to install EHR systems.

When HITECH Act took effect, storing files in the cloud seemed like uncharted territory for most physicians, who worried about privacy breaches. As a result, hospitals and physicians defaulted to hosting their own files on local servers. Epic was one of the few software vendors back then offering an all-in-one package covering a hospital's recordkeeping needs.

Using Epic is easier than trying to piece together better options from various software vendors, says Julia Adler-Milstein, a University of Michigan researcher who studies healthcare IT. On top of that, Epic will tailor each installation on-site to a customer's specific needs. What it doesn't have — and ditto systems created by competitors Cerner and Meditech, the other bigwigs in EHR — is a framework to connect to other facilities using competing EHR systems.

Notably, a 2014 RAND report singled out Epic as a roadblock to interoperability — ie, the ability to transfer a medical file from one hospital to another. With the company's rise, researchers wrote, came an increasingly walled-off system. "By subsidising 'where the industry is' rather than where it needed to go," the report said, the government propped up an EHR market "that did not have the level of connectivity envisioned by the authors of the HITECH Act."

See also: Connecting Healthcare Data - Interoperability

Hence, despite increasing popularity of EHRs, a government report released in August showed that only 56 percent of hospitals had received electronic records from other practices in the past year. Moreover, only 40 percent of these hospitals were able to merge the information into their own databases. 

The Office of the National Coordinator for Health Information Technology (ONC) also reported that EHR companies were engaging in "information blocking" to control referrals and enhance their market dominance. In September, the ONC launched a website where hospitals and doctors can lodge complaints against specific EHR firms.

Vendors need to open up their EHR systems a little more so that these work better with others, according to Adler-Milstein. The University of Michigan researcher hopes increased scrutiny pushes these companies to publish their APIs — the codes that let others access information in their systems — to allow other firms to build more user-friendly software.

Source: Mother Jones
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healthmanagement, electronic health records, health IT, exchange of information, interoperability, EHR Use of electronics health records (EHRs) is important in achieving coordinated care that leads to a better patient experience. While popularity of EHRs has increased — the percentage of U.S. hospitals using EHRs shot up from 9.4 to 75.5 percent between 20