Mommm! My EMR’s not sharing! - Cover

Mommm! My EMR’s not sharing!

If you are a parent, you’ve heard “Not sharing!” complaints before. If you’re like me, you’ve responded with a deep sigh and reluctantly set out to uncover what’s really going on in the family room in hopes of getting everyone to play nicely. You might have even delivered a few “riveting” lectures on important principles like cooperation, compromise, and fairness.

I wonder whether those lectures would help in healthcare, where the inability of different EMRs to easily share patient information can turn into a game of finger-pointing by vendors, providers, politicians, and pundits. These are not childish complaints, though. The current lack of interoperability is considered a major roadblock to reforming healthcare.

Among vendors, one in particular seems to be at the wrong end of many fingers: Epic. Competitors say Epic’s technology is “closed” and doesn’t support sharing with other vendors’ solutions. Some even point a finger at KLAS, incredulous that we include Epic’s Care Everywhere product in our HIE research. 

What’s most interesting, though, are the comments we hear from some of Epic’s own customers. Here are a few that I just pulled from the KLAS website:

“Epic focuses inward very much. Everything works very, very well if it works with Epic. Epic is kind of like Apple. If we stay in the ecosystem, things work very well, but if we try to go outside of the ecosystem, they do not.” (CMIO)

EpicCare Inpatient EMR has not demonstrated the interoperability that was promised. It has not been able to share data with other community EHRs or digest data from our regional HIE. It is, honestly, a tremendous disappointment.” (CIO)

“Epic is less open somewhat intentionally, and that is a big cultural change for our architects to think about. In a world where everybody says everybody has to share, Epic has not invested enough.” (CIO)

Some might be surprised to hear such remarks from patrons of the fastest-growing, highest-rated EMR vendor. The truth is that we hear similar comments about all EMRs.

Interoperability is a complex problem, but to at least get closer to the bottom of the “Epic isn’t sharing” concern, KLAS recently held 28 interviews with a mix of Epic customers, providers using other EMRs, and state/regional HIE organizations—all said to be connecting with Epic in one way or another.

Based on those interviews, we can clear up one thing right now: Epic does share. Consider that officially validated by an objective third party. Yet the matter isn’t that simple—the real questions are “How?,” “How well?,” and “How much?”  

We found that most of the Epic customers we interviewed were happy with their ability to send and receive patient data (i.e., CCDs). Non-Epic customers and HIE providers had a somewhat different point of view: the disconnect in how vendors implement interoperability standards can get a bit messy.

For more detail, check out the report Epic HIE 2014: Everywhere, Elsewhere, or Nowhere Else? If you’d like to see more or have any questions, drop me a line at