Healthcare IT Interoperability and EMR Interoperability Explained

Electronic Medical Record Interoperability is the Ability of Different Hospital Systems and Doctor Practices to Share Patient Data.

Examples of Patient Data Include Disease History, Physical Exam Findings, CT/MRI Images and Lab Values.

The US Government Measured Hospital Interoperability in Major Cities and Scored Them on Percent of Hospitals that Shared Patient Data.

Some of the Findings:
Cleveland 78% of Hospitals Share Patient Data
Miami 77%
Dallas 60%
New York City 59%
Chicago 58%
Boston 50%
Washington D.C. 44%
Los Angeles 41%
Philadelphia 35%

Some Hospitals and Physician Practices Do Not Share Data NOT Because of Technology Challenges, But Rather Because They Just Don't WANT To.

Hear a True Story of a 500+ Doctor Practice that STOPPED Sharing CT Images with a Local Hospital for Free and Instead Would Charge Patients to Copy Images to a CD, Which They Would Need to Take to the Hospital.

Sources:

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[Kelly-tduf]

I remember the pain of getting imaging off of CDs! On a few occasions, we even had to call IT to install a new program on our computer so we could open the files. What a nightmare.

[edwardglynn]

I suspect that interoperability increases when you have fewer ehr vendors in a location. I believe in Cleveland, Epic “owns” most of the beds while in Boston I suspect there is greater variability in EHRs. That would be a great graph to show: %interoperable c/w #of EHRs in a graphical location. I believe most interpretable issues are caused by software variability rather than nefarious practice. That said, I suspect healthcare business practices do question the value of interoperability on the bottom line while clinicians bang their heads in frustration at the obvious needs here.

[ryanweaver]

Laws, good work, policy, feedback loops, communities, markets…. All manner of people and organizations…. The Values embedded within these works matter so very much.

[chaunce]

Don't we all just love it when we are at our specialist and need to fax over the imaging yet we have the images on our smartphone! I wonder what the major medical system(s) of Cleveland are? Im from the Philly region and can say with full confidence there are a handful of systems to choose from. Jefferson, Tower, Virtua, Penn, Main Line. Is there a correlation between Interoperability and quantity of systems?

[RaminR]

Great video as always Eric!! Very informative!!

[AG-xqkj]

Enjoyed watching this – by the way, I’d love to get your thoughts on the current market for ASCs and viability of new entrants!

[cyrilsurendar]

This is excellent, thank you for this.

[modanq]

Cleveland has high interoperability due to monopoly/duopoly of hospital systems and EMR systems (EPIC)

[jenno]

Can you do a video about medical errors, especially with maternal mortality please?

[ryanweaver]

Open enrollment and health interoperability… these things matter a lot. Streams and pools and influence and mirrors. The needs of privacy, transparency and proper oversight can and need to bridge while minimizing leverage based leadership.

#LoveEVICTShate #stakeholdeconnectioms

[ericgombrich]

Another "angle" to this is that even independent practitioners (i.e., GPs/Family MDs) are averse to sharing data. The patient charts (aka "data") is the asset they accumulate over the course of a career that they ultimately "sell" as their retirement fund when they leave practice. If its ubiquitously available thru sharing, why would the next generation of MD's pay much for it? And the hard assets (equipment, etc.) of a practice will have depreciated too much to have significant value.

[ryanweaver]

Health interoperability may not exactly be Devine work… but it certainly helps us all elevate. The needs are real.

[YadhyraCaldeon]

I appreciate your efforts! 🙏 Need some advice: 🙏 I only have these words 🤔. (behave today finger ski upon boy assault summer exhaust beauty stereo over). What is this? 🤔

[nolanjekich]

Great content! One question I have for you. Is there certain policy, legislation or models that would advance interoperability throughout health systems? VBC is one way providers and health systems would advocate for advancing interoperability.

[aetu]

Its still siloed...within the hospital or doc practice...

[ryanweaver]

He's not even talking about rural health when oversight and certificate of need and stark law and influence networks shift in priorities... It's just so much.. we need better, badly.

[ryanweaver]

When we consider the concepts of homeostasis (one body)... and fragmented incremental improvement... a bit of a precursor to fractionated improvement... butterflies, bees, and turtles... so to speak... DNA replication process....

I am not an expert in DNA nor nuclear physics nor religious scholar... a very very real reason why diversity of thoughts and understanding of expertise while moving forward in positive and better work... Human centric positive feedback loops..

Translational medicine and they aren't the same but are related and connected... causations and correlations and influence splices. The regional work needs safe and effective interoperability with.... rights of individuals and groups... privacy, transparency and proper oversight...

Growth and process while also creating safe and effective space.... Health and climate are connected; as is the work, the needs of fractionated improvement while overlay and understanding of connections and needs of growth... Connections to community will and must help...

#LoveEVICTShate #E=MC2

[ryanweaver]

The work of safe and effective health sharing is very important. It is also important to have an equality amendment to the constitution where data usage and privacy, transparency and proper oversight is better understood and protected. The old school debate of trustee vs delegate theory of leadership and or stewardship is something we as a nation and world need to better understand. The mass evolution of information technology and concept of "i know better than you"... can have very deleterious effects. humans matter.

Of course expertise and discretion matter... these are not single use issues.

#LoveEVICTShate

[ryanweaver]

yes, I like community banks too and all types of organizations... breathe ya'll.

[ryanweaver]

They needs of medical ecosystems with blended lines of connections matter a great deal. The concentric circle (Venn Diagrams are a decent starting place... but it's three-four dimenstional and overlapping and time bound and in flux.. 5 dimensional "ish"...

A medical eco system has movement within it and has varied stimulus and response which gets more difficult to discern over time... some reactions begin, initial energy converts and off it goes.... the Values spinning to and fro.... (an aside... hate feeds itself in this fashion...). Now, those movements and shifts in those lines affect the medical eco system internally... but also the entire system effects the larger whole of healthcare at large... and those individual lines also affect the greater whole at different times... The honest and safe sharing of health data has value of honesty... which is also fraught with history, personal choices... value and fee for services... mental health and all sorts of

The health and energy infrastructure effect these matters but differently and by their nature bring other tools, needs and expertise and realizations to the "table"...

The AI stuff isn't a panacea... it's us... but a freeze frame version of us withe line extensions flowing with all of the other stuff (in it already)... the positive feedback loops need honesty (health interoperbility... with assurances of patients and providers and systems' rights)... it's a baseline... the disconnected stuff or back tracking into CD's or whatever may take these concepts and put a "safety" check on... it's true, but it also adds time and process to bastardizing stewardship and overly developed monetizations... where there are a lot of public funds involved... the defintion of grift and graft... but the safety and rights are real...

In another sector or sphere (ish)... connected but also it's own.... I have three bank accounts... one very local Credit Union, one large across state credit union... and one national/international bank.... Acute and systemic... local and larger context... honesty and kindness... I am not anti business/markets... of course not... I also have a healthy fear of over reach of any sector... The connections help some...We need better interoperability and safety and medical and infrastructure eco systems... without tearing down very needed learnings and systems in place.

#LoveEVICTShate