The majority of the nation’s hospitals and physicians now use electronic health records and most of these EHR users are already exchanging clinical data with regional HIEs

Pathologists tracking the adoption of EHR systems by hospitals and physicians will be interested to learn that, according to the federal government, more than 80% of hospitals and 50% of physicians now use these products. It is also reported that growing numbers of providers are exchanging data with health information exchanges.

Clinical laboratories and anatomic pathology groups have a big stake in these developments. Medical laboratory test data is an essential component to every patient’s permanent health record, which is why it is important for every lab to have interfaces with the HIEs serving their communities and regions.

Progress in EHR adoption has been significant. Currently the majority of U.S. hospitals exchange information with outside providers via health information exchanges (HIEs). That number was published by the American Hospital Association (AHA) in its 2013 Health IT survey.

AHA Health IT Survey Noted Rise in HIE Use, but Data Type Shared Varied

The AHA survey found that the type of data exchanged with outside providers varied. About 57% of hospitals electronically shared medical laboratory results and 55% shared radiology reports with ambulatory providers.

But, the AHA survey found that only four in 10 hospitals are able to securely exchange electronic messages containing patient health information with external providers. Furthermore, only two in 10 hospitals were able to electronically request and retrieve patient health information from sources outside their organization.

How EHR Adoption Is Helping to Advance Integrated Clinical Care

Some survey data offered a perspective on how EHR adoption is advancing the integration of clinical care. For example, less than half of hospitals in the survey routinely notified primary-care physicians electronically when their patients entered the emergency room and only about a quarter of them notified patients’ primary-care physicians outside their own EHR systems.

Even worse, only one in 10 hospitals provided patients the ability to transmit information from their medical records to a third party.

But while six in 10 hospitals share information with ambulatory providers, use of HIEs still has a ways to go to significantly impact healthcare quality and costs, suggested the ONC Data Brief blog. This blog is published by the Office of the National Coordinator for Health Information Technology (ONC).

Use of HIEs Rose Along with Adoption of EHRs

The use of HIEs has escalated along with adoption of electronic health record (EHR) systems. This was one finding in a report issued earlier this year by the U.S. Department of Health and Human Resources (HHS).

“Our previous analysis of AHA HIE survey data found that EHR adoption—in combination with participation in a regional health information organization—was associated with the highest rates of exchange of different types of health information across organizations, stated the ONC Data Brief.

Ohio’s Regional HIE Continues to Grow, but Barriers to Use Remain

Ohio’s regional HIE, CliniSync, is an example of growing HIE participation. Since it was established in 2011, CliniSync now has 141 hospitals committed to joining. Currently, 49 hospitals are live, along with more than 1,500 physician members.

However, EHR functionality may be a barrier to more active participation in an HIE. A survey of 81 member physician practices was conducted by the Ohio Patient-Centered Primary Care Collaborative (OPCPCC). Of those responding, 85% actively use EHRs, but they reported that their EHR technology presents barriers to embracing CliniSync’s full potential. Specific issues identified by the survey are:

1) The top EHR barrier to sending and receiving health information was a limited pool of providers capable of exchanging information. One-third of respondents said their EHR did not have the ability to incorporate the exchange of clinical information within their EHR workflow.

2) The cost of an EHR upgrade and HIE service were also top HIE barriers.

3) Many physician practices shared information with patients through a portal, but a large portion of them did not.

Matthew Swain (pictured) is a Program Analyst in the Office of the National Coordinator for Health Information Technology (ONC). He says that, with implementation of 2014 Health IT certification regulations, all hospital EHRs will have secure messaging capability and the ability to exchange medical information. (Photo in public domain.)

Matthew Swain (pictured) is a Program Analyst in the Office of the National Coordinator for Health Information Technology (ONC). He says that, with implementation of 2014 Health IT certification regulations, all hospital EHRs will have secure messaging capability and the ability to exchange medical information. (Photo in public domain.)

Some Hospital’s EHR Technology Limits Type of Data Exchanged

In the ONC blog, it was noted that less than half of EHRs were capable of secure messaging and exchange of medical histories, 42% and 37%, respectively. “We anticipate that the exchange of care summaries among hospitals will increase as hospitals implement EHRs certified to meet ONC’s 2014 Health IT certification regulations, which require secure messaging functionality and standarized clinical care summary structure and content,” wrote ONC bloggers Matthew Swain, a Program Analyst in the ONC Office of Economic Analysis, Evaluation and Modeling.

He noted that “meaningful use-eligible hospitals must use EHR technology with certified functionality, or a certified eHealth Exchange service, to achieve Stage 2 Meaningful Use transition of care requirements. Medicare and Medicaid Stage 2 incentive programs require hospitals to exchange clinical information using a certified EHR in order to qualify for incentive payments.

The 2013 AHA Health IT found that more than nine in 10 hospitals possessed EHR technology that met federal certification requirements to meet federal Stage 1 meaningful use requirements, and nearly six in 10 basic hospital EHR systems included exchange of clinical notes. These numbers were a 34% increase from the previous year’s survey, noted a report published by HealthData Management.

The survey numbers reported above that both hospitals and physicians continue to move forward with EHR adoption and use. At the same time, the more rigorous requirements for meeting Stage 2 Meaningful Use may slow EHR adoption by the remaining providers. That may be a good thing for clinical laboratories and pathology groups across the nation, because it gives them more time to collaborate with clients in developing effective LIS-to-EHR interfaces.

—By Patricia Kirk

Related Information:

Health Information Exchange among U.S. Non-federal Acute Care Hospitals: 2008-2013

AHA Survey: HIE Among U.S. Hospitals Has Grown, But Work Remains Health Information Exchange among U.S. Non-federal Acute Care Hospitals: 2008-2013

HIE Among Hospitals Grows, Still Needs Improvement

Ohio’s Health Information Exchange Survey For Patient-Centered Medical Homes

More Hospitals Adopting EHRs, Sending Health Data Electronically

ONC: Hospital EHR adoption, interoperability on the rise