I recently had a nice chat with a colleague analyzing HIT industry trends for Kalorama Information. Kalorama does industry research for the medical and life sciences for many of the major news and consulting organizations. I got in touch with her specifically because of Kalorama’s analysis on EHRs in 2012 which was used by Bloomberg Government for their (very expensive) EHR industry analysis for provider and vendors. She found that in 2012 one of the most immediate challenges for providers was implementing EHR systems that meet meaningful use standards. She also found that vendors were having trouble with interoperability and usability.
Fast forward to 2013; a lot has changed. Epic has grown to dominate many markets. Allscripts has a new CEO and a few new toys to play with. eClinicalWorks has become a force to be reckoned with in the small practice space. However, the challenges the providers are facing have changed. My colleague and I talked for a while about various organizations we each have worked with and came to the same conclusion: providers are now having trouble with interoperability and conversions of data.
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The majority of physician offices have implemented EHRs, but they must now communicate with other entities such as HIEs and ACOs. With the increase in mergers and acquisitions, we are also seeing an increased demand for conversions from one system to another. These problems involve a thorough understanding of the underlying data structure as well as a solid foundation in interoperability standards such as LOINC, HL7, SNOMED, and CDA. The vendors have the expertise to work on the problems for their products, but they are not enthusiastic about helping clients switch off their platform. Selling the EHR has been the primary goal for vendors in the past, not technical support that moves a client away from their product. Vendors are under the assumption that if they make switching off their product difficult, then clients will be less likely to undertake the conversion or integration with a product that is not part of the vendor’s family of products. While this is definitely true for disgruntled clients, it only makes it frustrating for clients who do not have a choice in the products they work with. This reality has led to some very important questions.
Where is an organization to go when their own vendor is not supporting their efforts? How do organizations extract meaningful data from such complicated or cloud based databases? How can we become self-sufficient in managing our data? How does an organization meet new institutional and government requirements? Consultants like myself can help organizations with these challenges, but vendors need to step up and start making products that play nice with others.
At the end of our conversation my colleague and I simultaneously came to the same conclusion: “Organizations feel like their data is being held hostage!”
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