Finally, a Giant Leap Forward Toward Interoperability

I learned earlier this week that five of the leading health systems are launching a new initiative to securely exchange electronic health data, with the first data exchange planned for next year. Kudos should go to Mayo Clinic, Geisinger, Kaiser Permanente, Intermountain Healthcare and Group Health for taking this giant, collective step forward. This innovative approach, titled the Care Connectivity Consortium, is the best prospect for major progress in interoperability that I have seen in recent years.

Will this exciting joint effort by some of the nation’s largest healthcare providers finally propel us toward achieving wide-spread adoption of standards-based, interoperable systems? While current standards and interoperability activities are slowly getting us closer to the goal of “anytime, anywhere, secure clinician access to health information,” we still have a long way to go.

Yes, we have been making incremental progress toward health information exchange. For example, standards coordination and harmonization efforts are increasingly visible through efforts like the HL7/IHE Health Story Implementation Guide Consolidation Project. Vendors are taking advantage of testing, demonstration, pilots and EHR certification opportunities. The ONC HIT Standards Committee continues to make recommendations to the National Coordinator for Health IT on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. And the ONC Standards and Interoperability Framework is showing evidence of visible progress with increasing adoption of the Direct Project specifications in live implementations.

Most recently, ONC released for public comment its Federal Information Technology Strategic Plan for 2011 through 2015. This plan clearly emphasizes the necessity of a standards-based approach to information sharing. The #1 goal is to Achieve Adoption and Information Exchange through Meaningful Use of Health IT, which confirms that interoperability and information exchange are critical to later stages of meaningful use. The plan also emphasizes that more rigorous standards and interoperability requirements will be required so that patient information follows patients to the point of care and informs them of critical health decisions.

But, is it possible that as a result of the willingness of these private sector healthcare providers to work together, we are about to experience a major advancement in this critical area that has been a barrier to successful EHR adoption and use?

In the 2011 HIMSS Nursing Informatics Workforce Survey, and for the first time, almost one-third of respondents mentioned lack of integration/interoperability as the top barrier to their success, followed by lack of financial resources (26 percent) and lack of administrative support (23 percent). Financial resources had previously been the number one barrier in the both the 2004 and 2007 surveys. The majority of the 660 nurse informaticists who participated in this research work in a hospital setting where they frequently experience the negative impact of disconnected systems on transitions of care, medication reconciliation and their ability to achieve optimal patient outcomes.

Clinicians and their patients have been waiting a long time for this day to come. Let’s hope we can finally say we are ‘almost there.’