Interoperability Is Delayed Again, Keeping Clinicians in Limbo

By David Lareau

Amidst the current health crisis, the October announcement that HHS is yet again delaying the enforcement of interoperability changes was hardly a surprise to anyone in healthcare IT. While predictable, the postponement means that clinicians will need to keep waiting for the much-needed changes designed to prevent information blocking and facilitate data sharing between providers.

HHS has delayed the interoperability updates, which were mandated in the 21^st Century Cures Act, to give providers more time to focus on competing priorities—most notably the COVID-19 pandemic that is consuming considerable clinical, financial, and IT resources. Unfortunately, the decision also pushes back long-promised enhancements that would simplify access to critical patient information within electronic health records (EHR) at the point of care.

Physicians have become all too familiar with the inefficiencies of EHRs; they hinder decision-making, decrease productivity, and are a leading cause of physician burnout, according to numerous surveys and studies. Burnout is a recognized threat to patient safety and care quality, and one of the most important reasons that healthcare leaders can no longer accept perpetual delays that are forcing clinicians to continue using inefficient systems.

The backstory

EHRs rarely serve the needs of clinicians. Instead, they make it easier to satisfy billing, coding, and reporting requirements. The typical EHR is a receptacle for information to facilitate the work of financial and analytics teams, and clinicians are tasked with entering the required data.

The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed in 2009 to spur widespread adoption of EHRs. Clinicians initially hoped that the legislation would encourage enhancements to make EHRs more clinician-friendly, but soon realized that vendors’ top priority was ensuring that eligible providers qualified for HITECH incentives. Rather than improving usability, HITECH-mandated changes arguably made EHRs less efficient, often creating clunky workflows that interfered with patient interactions and required clinicians to enter even more data.

When Congress passed the 21st Century Cures Act in 2016, clinicians thought relief might be on the way. The legislation recognized the importance of easing regulatory and administrative burdens associated with EHRs and established relevant goals and strategies, such as reducing the time required to enter health information and improving functionality and intuitiveness. It also sought to improve EHR interoperability between clinical systems and healthcare organizations so that clinicians could spend less time searching for critical patient information and more time delivering well-coordinated care.

After finalizing the interoperability rules in March 2020, a month later HHS announced that it would not enforce the rules for six additional months to provide relief to organizations facing the many challenges of COVID-19. With the October 2020 announcement, providers have even more time to delay the implementation of interoperability improvements. And no one really knows if or when additional delays could be forthcoming.

The story today

With the latest delay, clinicians remain stuck playing the waiting game while making do with inefficient, frustrating systems that interfere with clinician-patient interactions. A lack of complete, accurate, and actionable patient data can compromise clinical decision-making and patient outcomes, as well as delay care delivery. It can also hinder care coordination because providers across care settings have a flawed picture of a patient’s overall health status.

Meanwhile, the COVID-19 health crisis has underscored how badly our healthcare ecosystem needs solutions that facilitate the sharing of key patient information, such as preexisting conditions and medication histories, and efficiently serve the needs of stressed and burned-out clinicians. In other words, at the exact time clinicians are in desperate need of support in the form of interoperable data and efficient EHRs, we’re once again moving the endpoints and asking them to wait for improvements.

What’s next

Clinicians are understandably tired of waiting. Thus, healthcare leaders have a choice: They can continue to hold out for the implementation of government-mandated changes that may or may not serve the needs of clinicians, or they can embrace proven solutions that work with legacy EHRs to streamline clinician workflows, facilitate interoperability, and deliver clinicians the information they require for effective decision-making at the point of care.

Healthcare organizations do not need to replace their inefficient EHRs with brand-new platforms. Instead, they can optimize existing IT investments by integrating technologies that enhance usability and facilitate the exchange of clinical information. With the addition of tools that link relevant clinical concepts, for example, clinicians can immediately view pertinent diagnoses, medications, or similar information, regardless of where the concept originated. Instead of navigating multiple screens of data, users can quickly identify and interpret the information they need for the patient in front of them, improving care and minimizing frustration.

The latest interoperability delays are another setback for clinicians waiting for EHR enhancements—but they don’t have to be. Isn’t it time that healthcare leaders put a stop to the waiting game and embrace solutions that give clinicians the EHR efficiencies they deserve?

David Lareau is the CEO of Medicomp Systems, which provides physician-driven, point-of-care solutions that fix EHRs.