Per the Health IT Dashboard, 87 percent of hospitals in the United States started utilizing EHR software in 2015, a massive jump in a ten-year timespan from 25 percent in 2005. It’s clear use of EHR software has become the majority standard in a decade. Medical professionals stick by this method of health IT and information monitoring because it reduces error, streamlines processes, and ensures patient satisfaction. However, that doesn’t suggest the EHR software universe is snag-free. As with any software, problems can arise when a new EHR software product is released into a medical environment with a competing software product, and many sources note that a collective of medical professionals are raising concerns about one of the most pressing aspects of EHR software: interoperability. This aspect of EHR does not address the capability or functionality of the software itself, but rather data transfer between systems that run on medical monitors. It comes down to what’s called the CCD, or continuing care document.
In EHR Compatibility, the CCD is What Matters Most
The CCD, per Wikipedia, is an “XML-based markup standard intended to specify the encoding, structure, and semantics of a patient summary clinical document for exchange.” A compromised development by ASTM International and Health Level Seven International’s Clinical Document Architecure, it is encoded by EHR software as it contains a substantial amount of data including medications, allergies, problems, lab results, and patient chart data. This document is widely shared among medical computers and EHR devices. While not a complete medical record, the CCD includes just the most crucial information for effective medical care. It should be viewable via any standard web browser, but some voices lament that’s not always the case with a lot of EHR software, which leads to one of the most prevalent problems in healthcare IT…
EHR Compatibility Can be Terrible Because of Proprietary Formatting
Much like proprietary audio files or specific Apple chargers vs. Android phone chargers, not every EHR software product exports a CCD that will be read by another. At first glance, it may seem that transferring EHR between systems is just a file transfer, but how does that file transfer take place? If medical professionals bring their own devices, there are HIPAA security concerns—putting a patient’s data on a USB flash drive certainly isn’t secure. If one EHR system is web-based and another isn’t, how does an individual transfer the files? Does a physician-hosted EHR system function with a remotely hosted system or a cloud-based system? EHR compatibility problems can arise within hospitals—not just on a hospital to hospital transfer—if their IT departments decide on conflicting software environments, further causing connectivity problems. It’s a tough call between remaining secure, transferring the information from one medical monitor to another, and finding the quickest way to do so without compromising the data. Sometimes medical professionals have to print EHR documents and transcribe them to another platform, introducing human error and lengthening a typically automated process. EHR has been a wide success because of the Meaningful Use program and the HITECH Act, but medical staff still spend time bothering with menial tasks getting information from A to B. Health care companies are encouraging EHR software developers to start using open format file types instead of proprietary. There’s still a lot of room to improve, unfortunately.
EHR Compatibility Depends on the Medical Computer
Certain medical computers, while meeting FDA standards for near-patient use, aren’t compatible with all EHR systems—some medical monitors operate on a 4:3 aspect ratio, while EHR systems may utilize a 16:9 ratio to display a full gamut of patient information. A computer with an incompatible display may reject software installation or could limit the functionality of the software. Furthermore, highly advanced EHR systems require two-factor authentication, and if a system isn’t equipped with hardware to scan authentication methods, it may likely reject installation. Compatibility isn’t just a matter of speaking with other EHR software products—it’s a matter if the medical monitor in question can even support it.
A Way Out of EHR Compatibility Concern
Epic is one of the most prominent EHR systems used in the medical industry, and there’s a strong reason for it; interoperability is a key aspect of the Epic EHR system. There have been strides to see a universal healthcare data format for EHR systems, but it’s still a goal that not every company adheres to yet, even though Epic has been a key software product in that avenue. The Sequoia Project is an organization that advocates for nationwide health information exchange, and Carequality is a project within Sequoia designed to address interoperability between all parties in a healthcare IT network—addressing policy and technical agreements for the exchange of data. As for now, EHR compatibility can be addressed by ensuring all computers running a specific EHR—whichever it may be—remain in the same local “network.” Having a unified system with similar hardware cuts down on training time and bypasses any compatibility problems. Ensuring that the computers that run the EHR software are certified for that software is a must too—purchasing a computer deployment that ultimately doesn’t work with a given EHR system is wasted money. If your corporation goes with Epic for your EHR solution, keep in mind that many of our CyberMed computers are Epic and Cerner certified.
Hopefully in the near future we’ll see a unified, open format data file shareable among all EHR systems so we can focus on patient health instead of the technology supporting it. This unified system will take effort from several roles—the government, EHR providers, payers, and patients too. Some medical professionals argue that EHR developers must have proper incentives to cater to a unified system; it is a competitive market, after all.