Interoperability In The Smaller Facility
At the recent ONC Annual Meeting the ONC Principal Deputy National Coordinator, Dr. Vindell Washington, confirmed that the great majority of non-federal acute care hospitals now operate through certified electronic health record (EHR) systems, and that of this number 82 percent now routinely exchange lab and radiology reports, clinical summaries, medication lists and other data with external medical providers and partners such as ambulatory care facilities and doctors offices.
Dr. Washington notes that since 2008 this percentage has doubled, being only 42 percent 8 short years ago. Dr. Washington went on to note, however, that a recent ONC report highlighted that smaller facilities, rural hospitals and critical access hospitals (CAHs) have been less successful in their transition to an interoperable environment, and have been more resistant to adoption of an EHR solution that can provide the interoperability needed. Statistics show that rural hospitals in particular are achieving only half this engagement rate - in other words, the 2008 implementation rate is unchanged. 42 percent. No progress.
There are four domains against which interoperability is measured: Search, Send, Receive and Integrate data. Across the board in all four of these domains, smaller facilities are achieving half the engagement rate of larger organizations. ONC data offers no explanations for this and recommends further analysis of available data.
One possible explanation is the perceived high cost of EHR implementation, a cost easier to bear by organizations with larger and more flexible budgets, which can spread the expense across departments and time. Smaller operations do not have this level of flexibility and have been accordingly more resistant to the adoption of new technology.
However, the playing field has changed significantly in recent months. An increasing number of EHR offerings are available for small facilities, and even individual practices, as technology develops and vendors compete for market share. With most of the large players now locked in to long term contracts with EHR vendors, those vendors are looking further afield and targeting smaller facilities. Sigmund Software, itself a long-time leader in EHR for enterprise grade behavioral health and addiction treatment facilities, now offers a flexible and expanding range of EHR solutions which scale gracefully from one-person clinics up to multi-location and multi-state facilities.
This being so, it is likely that over the next two or three years adoption of EHR technology will show significant growth in the smaller practice / facility market, and that interoperability in this arena will naturally grow apace. As EHR systems become more affordable, and the benefits of interoperability are more clearly seen, so the traditional barriers to adoption are evaporating. As smaller facilities increasingly become able to work together with larger ones, and of course vice versa, because that is the point of interoperability, the benefits to practitioners and patients alike become too clear to ignore.
One big interoperable medical family is an admirable goal. A long-term one, perhaps. Nonetheless, it is an admirable goal that can drive profits and patient outcomes. Everybody wins.
Watch this space.