Interoperability improving, though rural hospitals still lagging
The number of hospitals engaged in integrating patient health information into EHRs grew by 40% since 2017, found ONC.
Photo: Al David Sacks/Getty Images
Interoperability continues to improve among hospitals, according to the Office of the National Coordinator for Health Information. As of 2021, 88% of hospitals engaged in electronically sending and obtaining patient health information, through either querying or electronically receiving summary of care records.
The number of hospitals engaged in integrating patient health information into EHRs grew by 40% since 2017, with about three-quarters of hospitals engaging in this activity in 2021.
These trends show progress in interoperable exchange, found ONC.
Rural hospitals, however, are still lagging behind their more urban counterparts, despite clear interoperability gains. Rural and small hospitals' rates of having information available at the point of care increased by over 26%, reaching 48% in 2021, and nationally it grew more than 20%, reaching 62% in 2021. Additionally, the usage of information received electronically from outside sources by rural and small hospitals increased at twice the rate of hospitals nationally (over 40% versus over 20%) between 2017 and 2021.
Yet these less resourced hospitals are still not on par with their counterparts, the report found, indicating the need to continue addressing challenges with having full access to electronic information from external sources.
WHAT'S THE IMPACT
Hospitals' improvements in interoperability could be attributed in part to the initial implementation of health IT provisions from the ONC Cures Act Final Rule and adoption of 2015 Edition certified technology, ONC found.
The Cures Rule updated the Health IT Certification Program to include new and updated criteria and standards that are expected to advance interoperability. Nearly 90% of hospitals have adopted 2015 Edition certified technology and are well-positioned to adopt these new criteria and standards. Other data shows that a large majority of hospitals have already done so.
Additionally, 74% percent of hospitals adopted the bulk data export capability as of 2021. The most common uses of bulk data export were for analytics and reporting (63%) and population and health management (35%), and less so for switching EHRs (12%).
Hospitals continued to use a variety of electronic exchange methods to achieve progress in interoperability. Compared to 2018, in 2021 hospitals were using more methods to send and receive a summary of care records (3.8 out of 7, and 2.9 out of 7, respectively), and find patient health information (2.7 out of 6).
HISPs and HIEs were the most commonly used electronic methods for sending and receiving information. The use of HIEs and interface connections with EHRs were the most commonly used methods for finding patient health information.
About four in 10 hospitals continued to participate in multiple networks, indicating possible challenges to exchange across different networks; according to ONC, this reinforces the need for having multiple networks. Policy activities that support cross-network exchange such as Trusted Exchange Framework and Common Agreement (TEFCA) will help reduce the number of different networks and methods that hospitals need to use to support exchange, ONC said.
Launched in early 2022, TEFCA aims to establish a universal policy and technical floor for nationwide interoperability, and simplify connectivity for organizations to securely exchange information.
Other provisions of the Cures Rule are being implemented now to help hospitals shift from simply establishing connectivity to optimizing and simplifying the use of multiple methods of exchanging information. However, some barriers to information exchange remain prevalent, found ONC. For instance, 48% of hospitals reported one-sided sharing relationships in which they share patient data with other providers who do not in turn share patient data with the hospital.
THE LARGER TREND
Given that a majority of hospitals (74%) reported the ability to integrate information into their EHRs, current policy efforts could increase the value of that integration, according to ONC.
For instance, recent actions were taken to improve the quality of data from external sources by advancing the use of specific data elements, such as through the United States Core Data for Interoperability (USCDI), and through the required use of standardized API technology using the HL7 Fast Healthcare Interoperability Resource (FHIR).
Efforts such as these should help ensure that information is available, integrated into the EHR, and used at the point of care – all of which, said ONC, have further room for improvement and will ultimately drive improvements in care and secondary use of data, such as for research.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
