Lots of hospitals—nearly all of them in fact—now have an electronic health records system.
But for now most hospitals and health systems are keeping their electronic patient records literally locked up and are sharing them only with the patients, providers or other parties affiliated with their health system
They lack the connectivity and wherewithal to build electronic record sharing beyond any group of providers not currently connected to their internal records system.
That’s the chief conclusion of a recent report analyzing how hospitals are sharing—or not—with other healthcare providers outside of their system from the University of California San Francisco. More than 95% of the nation’s nearly 6,000 hospitals have an electronic health records system. But less than one-third—29.7%—are sharing, sending and receiving electronic patient records with different outside provider groups. That’s up only slightly from 24.5% in the previous year, the study reports.
“I would have thought we’d see more movement in these measures, because electronic health records have been widely adopted for several years,” says University of California San Francisco Department of Medicine associate professor Julia Adler-Milstein.
Researchers looked at how hospitals are finding, sending, receiving and integrating electronic patient information from outside providers using data from the Office of the National Coordinator for Health Information Technology, a part of the U.S. Department of Health and Human Services.
The study analyzed data from 2,636 hospitals and additional numbers from 3,538 hospitals that responded to another federal government health information technology survey, which included more questions about how often hospitals used electronic patient data from outside sources.
Researchers found that only 19% of hospitals reported using shared data “often.” The study found that hospitals across the country have focused primarily on moving electronic health records from one institution to another, rather than integrating relevant subsets of information such as clinical notes, lab tests and other patient information in ways that would allow clinicians to easily learn what they need to know without having to read through a patient’s entire record, the study notes.
“At the most fundamental level, interoperability and clinician use of outside records is about whether your doctor has access to the information she needs,” Adler-Milstein said. “So, when we know that less than half of hospitals can do that, it’s terrifying.”
As a group, hospitals are spending lots of money on electronic records technology. The Health Information Technology for Economic and Clinical Health Act, or HITECH, in 2009 authorized $30 billion to help hospitals and providers adopt electronic health records. The American Hospital Association also estimates that hospitals at least doubled that amount with their own information technology spending, the study says.
But the University of California San Francisco study found 43% of hospitals reported outside patient information was available electronically when necessary, but more than one-third reported they rarely or never used it. The most common barrier hospitals reported to using outside information was their clinicians could not see it embedded into their own system’s electronic health record.
The study noted a few bright spots that reflect new ways of delivering care. The patient-centered “medical home” model, which aims to foster the use of primary care and encourages the use of patient data to manage health at the population level–for example, by tracking and following up on lab results and identifying those who use the health care system frequently–was associated with a higher likelihood that the hospital had outside electronic medical records available and that they were being used by clinicians, the study says.
Some hospitals are doing more patient record sharing—mainly because of mergers or in a move to stay competitive in their local healthcare market.
Two of North Carolina’s biggest health systems are now sharing electronic health records. In June, Carolinas HealthCare System, No. 67 in Internet Health Management’s Digital Hospital 500, and Novant Health, No. 62, integrated their electronic health records systems into one shared health information network for the region in and around Charlotte, N.C.
Carolinas, which runs a Cerner Corp. electronic records system, and Novant, which operates on a system from Epic Systems Inc., now operate one shared electronic health network with a data repository of nine million records.
The patient information available typically includes demographics, test results, transcribed documents, medical diagnoses and visit summaries. “This collaboration will improve efficiency and enhance patient care and allow providers to make more informed decisions because of a more timely and broader view of our patients’ health and medication information,” says Carolinas chief information and analytics officer Craig Richardville. “What used to take days or weeks to receive patient information from another health system will now be near instantaneous.”
In December Advocate Healthcare in Downers Grove, Ill., and Aurora Healthcare in Milwaukee merged to create a single $11 billion system that would share their combined market share in suburban western and northern Chicago and southeast Wisconsin. As part of the merger the two health systems announced they would consolidate and share digital medical data on a new electronic health records platform from Epic Systems. When complete in about three years about 17,000 providers will be able to electronically share patient data within the system, says Advocate senior vice president and chief marketing and digital officer Kelly Jo Golson.
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