Interoperability issues limits health IT adoption
The Nielsen report also highlights the limitations of one of the bedrock components of health IT: the electronic medical record (EMR). From the outset, the push for broader use of EMRs has been slowed by challenges of interoperability -- the extent to which one record can communicate with another.
But thanks in part to significant federal funding incentives, adoption of EMRs has risen sharply in recent years, though that only tells part of the story, according to Fegraus, who points out that all EMRs do not deliver the same value.
"We can track if a healthcare organization has an electronic medical record," she said. "What we haven't been so good at tracking yet is what does that mean for the patient? Do they have to repeat their medical history every time they see a new provider? Do they receive contact with their healthcare system at any other point in time except when they're in the room with their own physician?"
In the Nielsen poll, just 49 percent of respondents say that their doctors are able to share health information and know their medical history ahead of an appointment, a modest increase of three percentage points from last year.
Pearl, who in addition to chairing CAPP is also CEO of the Permanente Medical Group and the Mid-Atlantic Permanente Medical Group, sees three distinct phases in the evolution of the EMR. First is the basic adoption of a system at a hospital or physician's office, what could simply be a digital version of the paper file. Next comes a base level of interoperability, where distinct EMR systems can connect with one another so that information from outside care providers becomes accessible.
But ultimately, Pearl envisions the barriers coming down entirely, with the distinctions between one vendor's product and another's melting away as developers stitch together the various systems and the EMR becomes a truly holistic record.
"The challenge [for] the community is you have a lot of different electronic medical records, and the real question is going to be what it's going to take to force the makers of these systems, not to make them interoperable -- that means I can go into your system and see it -- but actually to allow the APIs to be accessed by third-party developers that are now going to allow the creation of a single system," Pearl said. "It's going to be the patient's system. And that's going to be, I think, the real holy grail of American medicine."
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