Creating meaningful interoperability in patient electronic health records
Why enhancing EHR connectivity, accessibility and ease of use is crucial for improving diagnostic care for patients
by Adam Plotts, Strategic Director, Clinical Technology for Labcorp
Adam Plotts has extensive experience promoting the use of web-based tools that capture clinical documentation, optimize workflow and enhance decision making. A licensed registered nurse with a bachelor’s degree in nursing, he specializes in clinical nursing and informatics and is knowledgeable of regulatory requirements for healthcare systems. His areas of focus include electronic health record implementation and workflow optimization plus clinical content development, focusing on industry-leading technologies that transform healthcare. He has served with Mayo Clinic, the Medical University of South Carolina and Columbia University and now leads strategic development of clinical technology for Labcorp.
My background in the electronic health record (EHR) space ranges from implementing EHR technology into physician practices to building reporting solutions in support of the Centers for Medicare and Medicaid Services’ “meaningful use.” This was a main source for the influx of physicians adopting EHRs and creating and sharing structured, reportable data. Since then, our industry has made massive investments in interoperability solutions, and we have seen many initiatives attempting to connect health systems. However, as I engage with healthcare providers and executives, I see a continued challenge in defining how we deliver data and achieve meaningful interoperability. To improve the experience, we should look for ways to increase connectivity, accessibility and ease of use.
How interoperability can improve EHR systems in healthcare
A perfect example of successful interoperability can be seen in an everyday banking transaction. We can visit an ATM anywhere in the U.S., simply insert our bank card, enter our PIN and get cash. The system understands our banking information and provides instant access to our funds wherever we are.
The gold standard for EHR interoperability within healthcare is to provide the same seamless experience. Ideally, a patient should be able to go anywhere in the nation and have a clinician who can view their full medical record as part of a standard workflow. The provider should not have to access or understand a new platform; the information should be readily available in a format the provider understands. Most interoperability solutions in the market make it difficult for users to retrieve data that resides outside of their EHR. While new solutions—such as launching an app that has already aggregated data or sending notifications that can ping trusted health networks for additional patient information—offer marked improvements, the overall process remains inefficient and incomplete. In a perfect world, the patient's medical record would include complete information and would be accessible wherever the patient is—at a walk-in clinic, at a specialist’s office or while traveling—without extra clicks or effort.
Making a difference with FHIR
How far are we from true EHR interoperability? There is movement, as the promise of Fast Healthcare Interoperability Resources (FHIR)-based interoperability continues to gain momentum. Simply put, FHIR is an emerging interoperability standard that enables faster data retrieval through software development resources and tools. We are now seeing FHIR-based platforms being delivered by the top EHR vendors. Even better, many third-party interoperability platforms are inching closer to the optimal state described above, where a provider can access a patient's record and the system automatically pings trusted networks, imports their data and auto-populates records into the patient's chart. From a technology perspective, our industry is making progress, but it's one thing to build the technology and another to see it validated, adopted and widely implemented.
Understanding the challenges in EHR systems
Quality care is dependent on connecting all parties, from patients to providers and various health systems to current data and insights. This critical need is underscored by chronic, complex conditions requiring patients to visit their primary care physician, multiple specialists and different clinics.
As an industry, we're at an inflection point on this key issue of interoperability because the need is strong, and the potential is great.
The main challenge is the way technology brings outside patient data into the provider's workflow. Currently, the outside data a provider receives isn’t actionable. While the provider may be able to see the patient's history based on data coming from specific sources, the system doesn't stitch the data together within the existing EHR to provide one comprehensive picture. Instead, the provider usually has to go through a time-intensive process navigating through multiple applications to get a full understanding of the patient’s history.
Providers require a solution that meets them in their workflow, showing all meaningful information through a single, integrated lens for each patient.
Beyond the challenges of creating a connected experience for the patient and provider, the problem is further exasperated with siloed initiatives across the country. While local and state-based health information exchanges have made tremendous progress in creating comprehensive records of the patient’s local activity, they are still limited in the reach of where the patient may be seen across the U.S. With collaborations like Carequality/CommonWell and the Strategic Health Information Exchange Collaborative, the promise of collapsing silos emerges. However, health systems inevitably will need to decide which collaboration or solutions work best for their organization, meaning the end result will still not meet the utopia for interoperability.
Leveraging Labcorp Diagnostic Assistant™
At Labcorp, we understand that meaningful EHR interoperability is a significant key to improving diagnostic care delivery. That’s why we’re proud to offer Labcorp Diagnostic Assistant, a powerful solution for managing patient care. With our ability to centralize every lab test completed at Labcorp facilities across the country, we deliver a single longitudinal lab history to the patient and/or provider. A provider can log in to our portal, look up a patient’s EHR and see all their test results, regardless of which provider ordered the tests or which Labcorp facility performed those tests. To date, more than 25,000 clinicians have enrolled in Labcorp’s clinical decision support program and have received more than 7 million lab-based clinical decision reports. Labcorp Diagnostic Assistant provides real-time access to this content at the point of care, allowing providers to make the most well-informed clinical decisions.
Labcorp supports EHR interoperability evolution by delivering information in a more connected way, allowing for readily available laboratory data for providers, and complementing advances in EHR technology.
We are passionate about delivering the right laboratory information to the right clinician, at the right time, to support the continuum of patient care.