Less than one-third of all U.S. hospitals in 2015 were able to locate, send, and receive EHRs for patients who have received care from outside providers, according to a study in Health Affairs.
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For the study, researchers assessed 2014 and 2015 survey responses from the CEOs of hospitals that belong to the American Hospital Association. Specifically, the researchers compared hospitals' 2014 and 2015 engagement in four core elements of interoperability involving external providers, including:
- Finding electronic patient information;
- Sending electronic patient information;
- Receiving electronic patient information; and
- Integrating electronic patient information.
The researchers found that while 71 percent of hospitals in 2015 had a basic EHR system, only 29.7 percent engaged in all four domains of interoperability—slightly higher than 2014, when only 24.5 percent of hospitals engaged in all four areas of interoperability.
According to the researchers, the two domains in which providers' EHRs made the most progress during the study period were sending information, with an increase of 8.1 percentage points between 2014 and 2015, and receiving information, with an increase of 8.4 percentage points over the same time period. However, there was no change in the percentage of hospitals engaging in integrating electronic patient information.
Further, the researchers found that while 43 percent of hospitals in 2015 stated that if needed outside patient information was electronically available, more than one-third of hospitals said they rarely or never used it and only 18.7 percent said they often used it.
Overall, the researchers said the findings indicate U.S. hospitals are more focused on moving EHRs from one location to another than on integrating electronic patient data, such as clinical notes or lab tests, in a way that would let providers learn what they need to know about a patient without having to review the entire patient record.
Jay Holmgren, lead author on the study and a doctoral student at Harvard Business School, said, "What this [study] means is there is potentially a significant amount of waste and inefficiency in hospitals," He added, "Without a system for getting electronic patient data to clinicians, the responsibility falls on patients and their families, who often resort to bringing printouts of records from one hospital to another. It just adds to the burden of being sick."
Separately, Dean Sittig—a biomedical informatics researcher at the University of Texas Health Science Center, who was not involved with the study—said, "Sharing electronic information between hospitals has been poor for many years." He added, "At first, we blamed it on lack of data in electronic form, and now that the vast majority of hospitals have [EHRs] and therefore the data is in electronic form, we need another excuse" (Rapaport, Reuters, 10/2; Holmgren et al., Health Affairs, October 2017).
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