EHR interoperability has been a hot topic lately and I have posted a number of notes about it. Here's a couple of the latest (see: What Will Motivate Hospital CEOs to Seek HIT Interoperability?; Revisiting EHR Interoperability; Standardized Content and Vendor Strategy). The major EHR vendors have been unable or unwilling to provide broad interoperability solutions, particularly between their systems and "foreign" systems by which is meant systems from competing vendors. A new and perhaps unexpected player has emerged to provide an interoperability solution -- e-prescribing giant Surescripts (see: E-Prescribing Giant Surescripts Emerges As A Player In Push For Interoperability). Below is an excerpt from the article about this news:
With health care providers scrambling to meet a government deadline this year to electronically send and receive patient information, an unlikely actor has emerged to facilitate that transaction. As the country’s largest electronic prescribing network, processing 1 billion prescriptions last year, Surescripts has amassed information on more than 200 million patients—from phone numbers to birthdate. Capitalizing on its network, it started four years ago offering health care providers the ability to exchange clinical messages using government-sanctioned standards. The service, slow to take off, has quadrupled since March, with health care providers exchanging nearly 1 million clinical messages in August. Jeff Miller who heads clinical network services, says that number is rapidly rising. Surescripts has signed up 130 health systems, including Geisinger Health System, Mount Sinai Health System, and St. Joseph’s Hospital Health Center....Becomes The second phase of meaningful use calls for health care providers to transmit a patient summary electronically in order to qualify for financial incentives. Instead of fax or phone, a doctor at Mount Sinai can now forward to another physician on a different electronic health record a patient’s discharge instructions, medications list, and diagnoses, among other things. Mount Sinai uses electronic health records from multiple vendors....Giving Surescripts a major boost is Epic. The dominant electronic health record connects to Surescripts’ clinical messaging service, and many of Surescripts’ clients are on Epic. Other major vendors that use Surescripts include Siemens (now part of Cerner) and Meditech. Surescripts says it added 1,000 hospitals to its network this year. The more it adds, the more likely it makes its clinical messaging service indispensable.
I posted a note two years ago that suggested that this could happen (see: Surescripts May Capture the Health Information Network (HIN) Business). Here's a quote from the Surescripts web page that provides more information about the Surescripts interoperability solution (see: What Is the Current State of Interoperability? – Part One).
Surescripts....will demonstrate how Surescripts’ Record Locator & Exchange (RLE) service can connect other EHR systems and HIE networks. This new offering from Surescripts will locate patient records stored in disparate locations, support electronic patient consent, and facilitate the exchange of information with the requesting care provider’s EHR, adding significant value in a streamlined process. With RLE, care providers receive comprehensive information about a patient with appropriate consent at the right time, in the right setting, and with the right context, improving care while saving time and money.
How was Surescripts able to pull all of this off with the EHR companies, who should have deployed broad interoperability solutions, twiddling their thumbs? As noted above and despite government pressure, the major EHR vendors did not want to provide interoperability solutions with competing EHRs. Surescripts was in the e-prescribing business and therefore had a deep understanding of how to interface with hospital EHRs in order to transmit drug prescription data to pharmacies. The company then exploited a new business opportunity by serving as a third-party to enable inter-hospital EHR communication. It looks like Epic is playing ball with Surescripts, at least for now, in terms of supporting its clinical messaging service. However and at least to me, there's something a little looney about an e-prescribing company providing this service.