Interoperability - It starts with the EMR vendors . . . Who's in the game?
Hundreds of EMR/EHR vendors are government certified, and as the origin of the patient record, they are expected to be interoperable. KLAS invited 12 prolific EMR/EHR vendors to attend the Keystone Summit to test, evaluate, and modify an interoperability questionnaire originally built by a group of provider experts KLAS called the fantastic four (see previous blog). With 32 provider executives also in attendanceùadding context to the discussionùthe vendor executives proceeded to debate, discuss, and modify the questionnaire until it was fine-tuned enough to receive their unanimous approval. Observers could watch and ultimately surmise the motivation, passion, and overall goals of each vendor, which seemed to range from being dead serious about solving the IO problem to just showing up to maintain an acceptable image. Some vendors came ready to partner with fierce competitors, while others kept their distance and stayed below the radar.
Top executives tossing out ideas, exchanging good-natured jabs, and a whole crew of them smiling arm in arm tells the story of what is possible. It will take great focus and commitment from all key EMR players to make a real difference. That did not happen at the Summit. Some vendorsùlike athenahealth, eClinicalWorks, and Epicùwere great verbal contributors and kept an intense focus from the first minute to the last, but others just quietly observed or left early. One vendor's whole team left after the first day; several vendor teams stayed to the end, yet gave no input or comment.
The over 100 Summit participants caught some glimpses of great humor or insight, like when Jonathan Bush (from athenahealth) electronically high-fived Judy Faulkner (from Epic) during the meeting with a yay Judy or stated to the crowd this is the longest I have ever sat in one place. And speaking as one with experience, John Glaser (from Cerner) described the magnitude of the undertaking by explaining how the government could impact the direction selected that day.
At the Summit's conclusion, a majority of the provider executives convened to give their feedback to KLAS. There was an overwhelming confirmation that interoperability really must start with their EMR vendors and that the process must include providers as partners in making the exchange of patient data successful. If these vendors work together, they can more quickly and effectively solve the interoperability challenge. Providers who saw a halfhearted effort from their vendor bemoaned the lack of engagement, while those who saw intensity in their vendor partners cheered. Early indicators of vendor commitment or passion may or may not play out in the long run. Is it better to give verbal agreement and not follow through or better to say less and do more? Perhaps there is a third alternative. I think of a story in the Bible (Matthew 21:28-32) regarding two brothers that gives another perspective: do what we say we will do. The KLAS measurement effort that was created and agreed on at the Keystone Summit will begin shortly. Let's see what it discovers relative to engagement, collaboration, and real progress.