From 2017 to 2018, acute care hospitals had a 17 percent increase in their ability to integrate data into their EHR.
EHR interoperability among acute care hospitals increased from 2017 to 2018, according to the American Hospital Association (AHA) Annual Survey, which was published by the Office of the National Coordinator for Health Information Technology (ONC).
Interoperability is a constant a challenge for many health systems across the country, but the report found that nearly half of acute care hospitals participated in all four domains (send, receive, find, and integrate) of interoperability. This number has steadily increased from 23 percent in 2014, to 26 percent in 2015, to 29 percent in 2016, to 41 percent in 2017, and then 46 percent in 2018.
The greatest increase of the four main interoperability domains came from the integration of data, which was a 9-percentage point increase. The ability to send, receive, and find documents electronically all increased from 1 to 4 percent.
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Also, electronic availability of patient health information from outside sources also increased by 10 percent from 2015 to 2018, resulting in 56 percent of hospitals having electronic patient health information available at the point of care.
However, hospitals faced issues when receiving patient information from an outside source, which led 38 percent of hospitals to rarely or never receive patient information electronically.
Fifty-two percent said information was not always available when needed, 50 percent said the information was available but not able to integrate into the EHR and 34 percent said the format or presentation of information caused burden.
Hospitals that did exchange electronic information ran into barriers when sending data. Sixty percent of hospitals said it was difficult to find providers’ addresses, 54 percent found interoperability issues with the exchange partner, and 52 percent said the exchange partner did not have an EHR.
When receiving data, 65 percent of respondents said there are providers that they share patients with, but those providers do not typically exchange patient data. Fifty-four percent said patient matching was a barrier when receiving patient data.
Health information exchanges (HIEs) are crucial for connecting communities and ensuring patient medical records are available at all times. However, interoperability remains a major issue for HIE implementation.
There are different ways to exchange summary of care records. In 2018, 76 percent of hospitals did not utilize a third-party sent or received summary of care records by mail or fax, an increase of 3-percentage points from 2017. Of the hospitals that did utilize a third-party, 49 percent used a standalone health information service providers (HISP).
According to the survey, hospitals used roughly three different electronic methods for sending and receiving summary of care records in 2018. Seventy-six percent of respondents said they use more than one electronic method to send health information, while 63 percent said they use more than one method to receive information.
Of to the hospitals that exchanged patient health information, 46 percent used a state, regional, or local HIE organization (HIO). Meanwhile, 38 percent used an interface connection between EHR systems, 34 percent used a single EHR vendor network, and 32 percent utilized a multi-EHR vendor network, such as the CommonWell Alliance.
The report found that 54 percent of medium to large hospitals participate in either national or state, regional, or local HIO. This compares to only 39 percent of small, rural hospitals that participate in HIE networks.
More specifically, 81 percent of medium to large hospitals participate in state, regional, or local networks, compared to 67 percent of small hospitals. Sixty-four percent of medium to large hospitals are active participants in national networks, compared to only 50 percent of small hospitals.
Non-critical access hospitals (non-CAHs) were also 12 percent more likely to participate in a HIE network than CAHs.
With the 21st Century Cures Act underway and set to improve interoperability, patient data exchange should continue to climb in the future.