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Thursday, September 14, 2017

Defining "Interoperability" down, an update

Pretty interesting Modern Healthcare article arrived in my inbox this morning.
Epic takes a step towards interoperability with Share Everywhere
By Rachel Z. Arndt

Epic Systems Corp. is making headway in the quest for interoperability and potentially fulfilling meaningful use requirements with a new way for patients to send their medical records to their providers.

The new product, called Share Everywhere and unveiled Wednesday, allows patients to give doctors access to their medical records through an internet browser. That means doctors don't have to have their own electronic health record systems and the information can be shared despite not having EHRs that can communicate.

"This is really patient-driven interoperability," said Sean Bina, Epic's vice president of access applications. "This makes it so the patient can direct their existing record to the clinician of their choice," he said, regardless of whether that patient is one of the 64% of Americans who have records in Epic EHRs or whether that doctor is one of the 57.8% of ambulatory physicians who use Epic.

The receiving doctors need only have a computer and an internet connection—a requirement that might have been helpful in the recent hurricanes…
As I've noted before, my world of late has been "all Epic all the time," mostly in my role as next-of-kin caregiver, as well as an episodic chronic care F/up patient. Kaiser Permanente? Epic. Muir? Epic. UCSF? Epic. Stanford Medical Center? Epic. (I think Sutter Health is also on Epic, but I'm not certain.)

They pretty much rule the Bay Area (which is a pretty good thing for us, net). Their national footprint is huge as well.

More from Rachel's article:
"Where we are now is we're looking at how do we get the data into the workflow of the clinician so it's not something else they have to do, it's just there," said Charles Christian, vice president of technology and engagement for the Indiana Health Information Exchange. "There is a massive amount of data that's being shared for a variety of reasons. The question is, how much of it is actually being used to have an impact on the outcomes?"
Interesting. Goes to my long irascible (pedantic?) beef regarding the misnomer "interoperability," which I've called "interoperababble." To recap: no amount of calling point-to-point interfaced data exchange "interoperability" will make it so -- should you take the IEEE definition seriously.

As do I.

"How do we get the data into the workflow so it's not something else they have to do, it's just there?"

Indeed. That is in fact the heart of the IEEE definition. To the extent that Epic's "Share Everywhere" service facilitates that "seamlessness" workflow goal, it may in fact be a substantive step in the right direction.
Though, it does appear to be "read-only." Minimally, the recipient provider would have to "screen-scrape" the data into her own EHR (or otherwise save them "to file") for "write" updating in the wake of acting upon the data. Chain-of-custody/last record update concerns, anyone?
We'll see. From Epic's press release:
Epic Announces Worldwide Interoperability with Share Everywhere
Patients can authorize any provider to view their record in Epic and to send progress notes back

Verona, Wis. – Epic, creator of the most widely used electronic health record, today announced Share Everywhere, a big leap forward in interoperability. Share Everywhere will allow patients to grant access to their data to any providers who have internet access, even if they don’t have EHRs. In addition, using Share Everywhere, a provider granted access can send a progress note back to the patient’s healthcare organization for improved continuity of care…
"Send a progress note back?" Perhaps that might suffice to allay "last update" concerns. Perhaps. A fundamental issue in QA broadly is that of "document version control."


Have you registered for the Oct 1st-4th Santa Clara Health 2.0 Annual Conference yet? Hope to see you there.

More to come...

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