- Healthcare organizations are still struggling with the basics of health information exchange and interoperability, with more than 40 percent of respondents to a new Black Book Research poll admitting that they have significant difficulties exchanging data with other providers.
Data standards issues, EHR vendor interoperability concerns, and integration shortfalls are all preventing providers from using external data for clinical decision-making, leaving organizations unprepared to tackle the population health management and quality reporting projects required for success under value-based care.
The poll of more than 3300 EHR users revealed widespread concerns about the ability to leverage big data for enhancing patient care.
While 81 percent of physicians operating within integrated delivery networks look to their core health system’s EHR to enable population health management and value-based care, those health systems are not having an easy time of generating complete, accurate, and trusted data sources.
A quarter of respondents said they are simply unable to use any data received electronically from external sources. Twenty-two percent said the data they receive is not in a format that is useful to them. Seventy percent of hospitals do not use patient information from outside of the EHR because they cannot integrate external data into their EHR systems’ workflows.
And twenty-one percent of physicians stated that even when they can view patient data, they do not trust that it is accurate enough to use for decision-making.
As a result, providers continue to be skeptical about their ability to engage in value-based care while meeting regulatory requirements such as MACRA. Eighty-two percent of independent physicians questioned their data analytics competencies, stating that they are not confident they have the data analytics skills and interoperability capabilities to take on financial risk.
"Physician groups continue to lack the financial and technical expertise to adopt complex EHRs which are compulsory to attain higher reimbursements by public and private payers,” said Doug Brown, Managing Partner of Black Book.
Instead of trying to address these technology issues themselves, independent physicians are likely to seek the protection of larger health systems. Ninety-two percent of hospital executives said they are anticipating a flood of physician acquisitions in 2017 as practitioners seek protection from the pressures of MACRA.
"Integrated delivery network EHRs are the future's source for trusted provider data integration and leading to the increase in physician EHR replacements in line with the hospital system,” Brown added. EHR replacements in recently acquired physician practices are increasing by 52 percent, he said.
But acquisition and employment may not be a silver bullet for physicians looking to become part of a larger technology network. Even when integrated delivery networks actively pursue interoperability with business partners, data exchange problems often abound.
In a previous Black Book survey from April of 2016, fifty-seven percent of organizations said their EHR vendors are responsible for data siloes, connectivity defects, or active information blocking that derailed efforts to move patient data across organizational lines. Instead of waiting for vendors to fix these issues, many providers said they were starting to develop their own private health information exchange organizations to connect regional partners.
EHR vendors spent the majority of 2016 combatting user perceptions that they were less concerned about interoperability than about turning a profit, with varying degrees of success.