Why are so few sharing inside the family? Same-vendor connections should be easier!

Transparency around vendor performance is the passion at KLAS. It all started in 1996 when Scott Holbrook, Leonard Black, and I debated how best to measure vendor performance and transparently report it to the provider community. Had I known how difficult starting KLAS would be, I likely would have opted out. But considering the opportunities we have had to help providers and the wonderful relationships we have established, I am so glad I opted in! Transparency is a good thing for understanding what is real; knowing the future is not. We could choose not to confront a perceived insurmountable challenge not knowing there was a great reward behind it.

Let's apply the transparency lens as we look at the success provider organizations have achieved in sharing patient records with other providers who have the same EMR vendor. It would seem that communication within the family (same vendor) would be the easiest connection type and the most prevalent. KLAS' October 2015 interoperability study provides clarity regarding how well same-vendor sharing is working. Let's take a quick look.

Providers using athenahealth, Cerner, eClinicalWorks, and Epic say their vendor's tools make it easiest to share with other providers using the same EMR. Barriers still exist around getting the right patient and around comfort with the legal and security issues that are standing in the way of success with three of these four vendors. While eClinicalWorks' Electronic Health eXchange (eEHX) solution -  regional sharing approach - is not in prevalent use, 2 of the 29 eClinicalWorks clients who participated in the study referred to eEHX as a real win for them, validating that it is real and works. One client stated, eClinicalWorks has been easy to connect with because they have a hub that connects all of their customers together. The other reported, It is easiest for us to connect to other organizations using eClinicalWorks, but that is only because we can connect using the HIE.

athenahealth's clients enjoy a simpler SaaS approach that extends the easy exchange beyond a region, a fact that was proactively validated by many of the 22 athenahealth participants in the study. One comment reflects the general theme from clients: When providers connect to an athena system one time, they are able to tie into athena's systems from all practices. Their SaaS functionality makes connecting to them really easy.

Cerner clients can contract for Resonance, Cerner's solution for connecting other Cerner clients. Two of the forty-two Cerner clients commented on their Resonance success; one is live with the solution and the other is in a test or semi-live mode. One client stated, Right now we are using Cerner Resonance to query another facility's EMR. We are still in the early stages because while the functionality is there, the usability isn't where it needs to be. The other gave details: Cerner is using their Resonance solution to connect all of us together. We are in the testing mode right now. In a week or two we were connected to another hospital and were testing with them.

All 69 Epic participants in the study have Care Everywhere, Epic's sharing solution. When a provider goes live on Epic, sharing with other provider organizations using Epic begins immediately. We heard a stream of proactive affirmation on the ease and success of connecting to other Epic clients. One recent Epic client offered, The day we turned EpicCare EMR on we had 42,000 messages exchanged with outside organizations. I was fascinated with the whole Epic concept of instant, unrestrained sharing.

How did one vendor vault ahead in terms of sharing patient records within their client base? Those providers enjoying the benefits state that the real-life barriers to sharing are mostly gone. Consent, legal responsibility, security, and technical underpinnings no longer block the way. Other vendors are kicking themselves for not seeing the possibility years ago (no one really knows the future). How long until we see the same success with sharing between disparate EMRs?

NOTE: In the same spirit of transparency, I'd like to share where the letters in KLAS are today. Scott (the S in KLAS) is currently in Hong Kong serving an 18-month mission with his wife, Joy, an RN. Leonard Black (the L in KLAS), with his sweetheart, Susan, is building homes in the Philippines for those that lost theirs in typhoon Haiyan in November 2013. Adam Gale (the A in KLAS) is KLAS' president and oversees all that KLAS does. And me, the K in KLAS, I am still pushing for transparency . . . and writing blogs :) .