EHR interoperability has become an omnipresent challenge. In 2020, before the pandemic struck, the issue got on the list of the top 6 leading health innovation priorities. However, with the pandemic wreaking havoc across the US, the priority of interoperability skyrocketed. Why so? To solve the pandemic challenges efficiently, providers needed to ensure health information availability. This motivated Itransition and other vendors to provide EHR optimization services with the focus on interoperability. And
there came a challenge previously unacknowledged—the sheer number of diverse EHR systems in use.

Scope underestimated

Though the majority of providers use several EHR solutions, these tools may be fragmented. On
average, a single provider can employ as many as 16 disparate EHRs across their affiliated practices.
Besides, the logic and structure of those solutions are not identical. Some of them may have specific ways of capturing and storing health information.

While in some cases it’s about the need for specialty solutions (behavioural health, oncology, etc.), in other it’s nothing but the lack of productive dialogue among partners. Luckily, industry stakeholders came up with promoting another way of sharing health information—establishing health information exchanges (HIEs).

HIE: what & how

Health information exchanges are programmatic solutions that allow hospitals, providers, their patients, labs, and other medical facilities to exchange patients’ medical information easily and securely. These solutions spare the key actors the trouble of integrating with disparate medical systems. Besides, timely sharing vital patient information can power informed decision-making at the point of care and allow providers to:

·Reduce unplanned readmissions

·Avoid medication errors

·Improve diagnostics

·End duplicative testing

Given the
promise HIEs hold, state governments have taken up the solutions and started
investing in them. As a result, diverse HIEs operate statewide and cross-state.

Statewide HEIs in the COVID-19 fight

Statewide HIEs work like a network cast across several providers. Interestingly, the partnership among participating providers is not a prerequisite here. These statewide networks link several providers without
establishing a connection between facilities and are capable of identifying health trends. Such HIEs assisted in clinicians’ work during the pandemic crisis in several states.

Integrated with the Southern Nevada health district and the State Public Health Lab, HealtHIE Nevada provided seamless access to the health district reports data and coronavirus test results. Besides, HealtHIE’s team prepared electronic case reports for the Southern Nevada health district. This effort consists in packaging up COVID-19-positive patients’ medical information together with follow-up recommendations. The team also tracked other conditions and diseases that might affect the patient’s recovery process. What’s more, the HIE offers access to its portal, HealtHIE Chart, free of charge. This solution stores the medical records of all Nevada residents.

Another statewide HIE, KONZA, has assisted in the COVID-19 fight across Kansas. KONZA offered de-identified information of COVID-positive patients admitted into a hospital or the ER. The HIE also provided an alerting platform that allowed users to track their patients who were diagnosed with COVID-19 or suspected of being infected across the state’s hospitals. This allows care providers to stay informed about their patient’s health situation even if they got admitted to a hospital out of their hometown. In their turn, clinicians from the receiving hospital could gain access to longitudinal medical data on that patient, including information about chronic conditions, previous care episodes, medication plans, and allergies. This considerably improved care efficiency in critical situations.

As the initial effort proved successful amidst the COVID-19 pandemic, KONZA’s team decided to take a step further and offer valuable data to hospitals and providers that have seen a recent upsurge in COVID-19 cases free of charge and regardless of their geographic location.
Today KONZA spans the home state of Kanzas, Missouri, South Carolina, Georgia, Connecticut, New Jersey, Louisiana, and Mississippi. However, there’s a limitation here. With KONZA, hospitals and healthcare providers can only view the data on patients on site. Downloading or sharing the data among clinicians is not available. At the same time, such roadblocks power the rise of full-scale
regional HIEs.

Regional HIEs on the rise

Amidst the pandemic, directors of several statewide HIEs have recognized the need to ensure health information availability beyond state borders. Aiming to expand their coverage and service offer, six successful HIEs created a new entity—Consortium for State and Regional Interoperability (CSRI) in February 2021.

The new network is to unite HIEs across California, Nebraska, Iowa, Maryland, District of Columbia, Arizona, Indiana, and Colorado. Now the HIEs stakeholders work on harmonizing their technologies and standards to provide seamless interoperability and deliver common services. Launching CSRI will mean setting up a large health data utility that stores medical records of 80 million US patients.

Summing up

The COVID-19 pandemic has put the US healthcare system under enormous stress. However, in these turbulent times, providers and health IT vendors have invested a lot of effort to ensure interoperability and full-scale health information availability in one way or another. While interoperability roadblocks still exist, projects like CSRI look inspiring. They prove providers and their IT partners are willing to go the extra mile to ensure interoperability via technology harmonization and standardization. At some point, those efforts may lead to ensuring health information interoperability nationwide.