EHR Interoperability 2024

In 2004, EHR interoperability became a government mandate to make patients’ health data—regardless of where it originated—complete and accessible at the point of care. While most EHR vendors have progressed in their ability to connect to national record exchanges and HIEs, healthcare organizations report that government data-sharing standards are still inadequate and unenforced and that EHR vendors often do not consistently facilitate needed data sharing. Additionally, healthcare organizations often feel unempowered to improve interoperability for their clinicians and patients.

This lack of progress from industry stakeholders has left clinicians’ needs unmet. Based on feedback from over 500,000 clinicians, this KLAS Arch Collaborative report shares, for the first time, clinician perspectives on EHR interoperability—examining end-user satisfaction with external integration, needed improvements to how clinicians receive external patient data, and best practices from high-performing healthcare organizations.

External Integration Is Worst Part of Clinicians’ EHR Experience, Most-Requested Physician Fix

Regardless of EHR vendor, interoperability is a major pain point for clinicians amid an already painful EHR experience. Among the 11 metrics used to calculate the Net EHR Experience Survey (NEES), clinicians are least satisfied with external integration—only 44% of respondents agree their EHR provides expected integration with outside organizations. In particular, physicians most frequently cite interoperability as a challenge and report that it is their top fix request, noting that external patient data often isn’t readily available in their EHR and, if found, is difficult to leverage (see next section). Of all clinical backgrounds measured by the Arch Collaborative, physicians have the lowest average NEES—22 points lower (on a -100 to 100 point scale) than the average NEES of other clinician types.

Clinicians’ External Data Needs Are Not Being Met; Lack of Accuracy, Relevance & Accessibility a Major Pain Point

The Arch Collaborative asked over 33,000 clinicians about their experience with using outside patient data, and many emphasize that data from outside sources is too often inaccurate, irrelevant, or difficult to find. 47% of respondents report they can’t quickly find important patient information from outside organizations, and another 47% say they have to sift through duplicated data.

Few Healthcare Organizations Achieve Successful Interoperability for Clinicians—What Best Practices Do Top Performers Suggest?

Most healthcare organizations are struggling to meet their clinicians’ interoperability needs, with most users feeling external integration doesn’t function as it should. However, improved interoperability is possible—the Arch Collaborative has validated 17 organizations where 70% of clinicians or more agree that external integration meets their needs (see chart to the right).

To understand these organizations’ keys to success, KLAS spoke to executive leaders from these top-performing organizations. The following best practices are based on these strategies and detail ways that others can better improve interoperability for their end users.

Best Practices from Top-Performing Organizations

Executive Perspectives from Top-Performing Organizations

Commit to sharing data: “We are not all [sharing data]. . . . [Vendors should have] data sharing settings turned on by default.” —CMIO

Coordinate with core sharing partners: “[Organizations should] identify their network. It can be overwhelming to share data with the entire country, but in a region, there are usually 10–20 health systems that are responsible for over 90% of shared patient data. Sharing data with those health systems is doable.” —CMIO

Focus on key health measures: “We prioritized the mapping of key preventive health measures. We basically said we want to be targeted and strategic, so we looked at things like A1c, colorectal screenings, hepatitis C screenings, and CT/NG screenings. We chose a subset of procedures and imaging tests to squeeze as much usable data as possible from our trading partners, and we put that data in the physician workflows. If we have A1c data from another system, it can’t be buried in a big document. It has to be in normal workflows.” —CMIO

Educate end users: “I was with a physician rounding recently, and they asked me how to connect to our outside data source. They had been at our health system for 18 months. I felt terrible that it took that physician so long to reach out and ask that question. I added the connection, and when I revisited the physician a week later, they said it had already saved them countless clicks and logins.”  —CMIO

Involve EHR vendors as much as possible: “The entire industry relies on standards, but the standards are too broad. The standards need to be baked into technology vendors’ offerings. Far too much responsibility is placed on healthcare organizations to wrangle what is a hugely complicated problem of data mapping. Vendors want to give people flexibility, but they have shot themselves in the foot. I wish my job could be made irrelevant by all EHR vendors. I think they could solve a lot.”  —CMIO

Next Steps: Measuring Your Clinicians’ Experiences with Interoperability

Healthcare organizations striving to improve EHR interoperability need to know their current position with interoperability. The Arch Collaborative measures clinician satisfaction with EHR interoperability as well as with other factors important to EHR success. To participate in the Arch Collaborative, go to https://engage.klasresearch.com/klas-arch-collaborative/. Additionally, organizations who want help establishing regular touch points with core sharing partners can reach out to their KLAS provider success manager for assistance.