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Some EHRs in danger of missing data connections

Technology consultants recommend that medical practices not become “electronic information silos” and talk electronically to all parties that will exchange information with them.

By Pamela Lewis Dolan — Posted Nov. 28, 2012

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Many physicians could discover that just because they implement an electronic health record system that is certified to meet meaningful use doesn’t mean it is capable of connecting with all the entities with which doctors want to exchange data.

Experts are advising doctors who are adopting EHRs to think about what data exchange they plan to do and ensure that the system is capable of doing it. And that goes beyond checking for meaningful use certification.

“Notwithstanding the improved information flow that an electronic health record makes possible within a hospital or medical practice, even certified EHRs often have limited capacity to share important care-related data with other EHRs, in effect creating electronic information silos,” said Kenneth W. Kizer, MD, MPH, director of the University of California, Davis Health System’s Institute for Population Health Improvement, in a statement.

The IPHI developed the “HIE Ready Buyers’ Guide,” which addresses these limitations by rating EHR systems on their ability to perform certain data exchange functions. For practices in California, the guide also lists health information organizations in the state and the services they offer.

Customization often is needed for information to flow between some EHRs or between EHRs and health information organizations, Dr. Kizer said.

Dixon Davis, vice president of business development at AAPC Physician Services, a practice management consulting firm based in Salt Lake City, agreed. “You can have the same system implemented in many different ways,” he said.

Meaningful use certification ensures that EHRs can send data from one point to another, Davis said. “But information exchange from one party to another is different than tying five entities together.” Meaningful use eventually will get there, he said, but the exchange requirements EHRs must meet to be certified for meaningful use are limited mostly to exchange between one organization and another, not across multiple settings.

Dr. Kizer said the first edition of the guide included only vendors that participate with California’s regional extension center and agreed to attest that their systems had certain capabilities. They also had to share pricing information. The guide includes a limited number of vendors, but it will be expanded on a rolling basis as more vendors send the required information (link).

Physicians will need to talk with the organizations with whom they plan to exchange data — including labs, other practices, hospitals and health information organizations — to find out what capabilities their systems must have, Davis said.

He said the process can be very overwhelming. “When you start to feel that anxiety, just get into it step by step. And meaningful use is a good way to do it, just because that’s where you are going to be paid money just to follow those recommendations for moving forward. And they will step you … by stages.”

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