Putting Portability Back in HIPAA: Part 3

Disparate Systems Causing Backlog

If you have been keeping up with the blog series so far than you should be up to speed with the current state of affairs facing HIPAA regulations and Health IT systems and how to make HIT systems more interoperable. This iteration of the blog series will focus on why these systems need to be more interoperable, the costs that limited interoperability are creating and the benefits that would come from improved interoperability.

Part 3: Why Should We Make These Systems More Interoperable?

The question might seem a bit obvious. However, it keeps coming up and no one has definitively answered it through action. I have made the case for how Open Source can improve interoperability in my prior post and in a recent White Paper, How Drupal Can Make Us Healthier. Now I would like to focus on a few inefficiencies and negligent practices that are a direct result of poor system interoperability and why we should be making the effort to improve the landscape.

Due to the closed and proprietary nature of the majority of the EMRs on the market there is a staggering degree of dissatisfaction among physicians. Limited interoperability between systems is causing physicians to spend more time on documentation, which is stunting the ability to see more patients. Lack of interoperability between systems is “sapping efficiency and enthusiasm” across the board . This is creating the desire among hospitals and Accountable Care Organizations (ACO) to replace their current solutions. Even though it can be argued that “New is Better” I would disagree and argue that the replacement systems could end up being a colossal waste of money.

HiResWith some basic back of the envelope math a complete EHR switch equates to an 8 – 9 figure endeavor for integrated health delivery systems. With the national healthcare expenditure expected to hit $4.2 Trillion by 2018 this does not seem like the right path moving forward. Especially when “21% – 40% of Healthcare spend is wasted due to inefficiencies” this strategy will just continue to perpetuate the problem and increase the financial strain on our economy. For what is worth, technology is always changing and there will always be something promising better results.

Another critical functionality issue with EHRs that highlight a lack of interoperability is the need for multiple connection points to clinical and non-clinical systems. This is required to effectively complete billing, order processing, documentation and such, yet each system has a different interface and lacks seamless system wide integration. Rather than the data porting over to the various systems, employees and staff are now tasked to take this on manually and make up for the shortcomings of these systems. This opens the door for human error, improper reporting and critical data inaccuracies. If we have learned at least one thing over the years with technology we should have clearly learned that one monolithic system that controls everything simply is not feasible.

The American Medical Association (AMA) records 50 different physician specialties and multiple different disciplines from nursing, pharmacy and physical therapy all with the need for a unique interface. However, the major EMR systems do not provide that needed flexibility, but rather they are all configured with a “default” user interface (UI). This “lack of coordination can lead to duplication of tests and procedures — a broader problem that costs the medical system $148 billion to $226 billion a year.

Lack of interoperability among Health IT is a plague that continues to cost the health sector billions in wasted money. This cost is eventually shifted back to the patient, and often times it is more than just a monetary cost, patients are suffering from lack of care, poor experience, misdiagnosis and conflicting drug prescriptions that can put their lives at risk. This is in large part due to the lack of IT system interoperability. Putting patients at risk should be enough of a reason to improve health system interoperability, but tie in the financial strain to the economy and the question becomes “why haven’t we made these systems more interoperable” rather than “why should we make these systems more interoperable.”

In Part 4 of the blog series I will tie it all together and focus on advancing the Health IT sector forward to improve patient outcomes and enhance the patient/physician experience.


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