EHR interoperability: A necessary evil or an opportunity?

In recent years, government incentives, policy changes and industry standard initiatives have stimulated and encouraged the development of more seamless integration and interoperability between disconnected HIT and HIS systems. However, bringing together diverse IT systems across health systems -- and across the country -- is easier said than done. Despite national efforts to incentivize the exchange of health information, progress hasn’t been made at the rates you might expect. In fact, some people are wondering if vendors are responsible for slowing down the rate of HIT adoption -- claiming that vendors do not benefit from enabling their unique systems to "work well" with others so they are not focusing on enhancing these necessary interoperability capabilities.

I disagree. I would like to think that healthcare vendors care about more than just bottom dollar, and in fact have a genuine interest in truly improving care. The truth is that vendors are well past the point of seeing interoperability as a "necessary evil," and instead view it as a positive and necessary evolution of EHR technology. Since it is not realistic to expect all health organizations across the entire country to standardize on one EHR, interoperability remains a critical component in improving healthcare via the electronic exchange of information. In this way I think vendors are starting to view interoperability as a given requirement, just like security, or support for a “universal language” through code systems. Interoperability standards give vendors a chance to differentiate on other EHR features, like decision support capabilities or mobile functionality, while not having to worry about how to operate in a real-world, multi-system environment.

Exactly analogous was the situation in the 1990s when proprietary PACS systems emerged as add-ons to CT and MR scanners. A few vendors recognized the opportunity to create a common framework for interoperability, realizing that sharing images would be in everyone’s interest and that locking customers into proprietary environments was a zero-sum game. As a result the DICOM standard was born, the multi-billion dollar PACS industry emerged, and everyone was a winner – providers, their partners and vendors.

Seamless interoperability between HIT systems, such as EHRs, is a necessity for health information exchange to be successful in improving care. In that respect, policy, vendors and patients all have vested roles to play in achieving this universal goal. 

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