I have posted a number of previous notes about the need for interoperability among the various hospital and health system EHRs (see, for example: Do Hospitals Really Want Interoperable E-Health Records?; NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals). I believe that the lack of such a solution has partly been the fault of hospital executives who did not want to make their hospital records portable and partly the fault of EHR vendors who wanted to enhance their market position and please their client base. Well, a decade has passed and Judy Faulkner, the CEO of Epic, has suggested at her annual users conference that the global "interoperability" is the wave of the future but particularly for Epic clients (see: Judy Faulkner touts interoperability at Epic users conference). Below is an excerpt from the article:
Epic is working to take interoperability global, CEO Judy Faulkner told more than 10,000 attendees at the company's annual Users Group Meeting. "You've eliminated the silos from within your organization," said Faulkner, speaking at Epic's headquarters in Verona, Wisconsin...."Now it's time to eliminate the silos from outside." Faulkner was referring to Epic's One Virtual System Worldwide initiative, which it launched early this year. The initiative enables "clinicians across all organizations using Epic" to more easily gather, share and interact with health data no matter the location and presents it in a unified view....As is often the knock against the company, the focus on exchange across Epic customers is not quite the same as true interoperability. But Epic said the initiative does include "organizations that use other EHRs." It certainly represents an Epic-esque approach to the idea of more widespread data sharing. Given the scope of Epic's customer footprint, with nearly two-thirds of U.S. patients and increasingly more in Europe, it's on a scale that could credibly live-up to the project's bold name.
I think that we are still at a point where Faulkner's vision of interoperability puts Epic customers first in line. Given that Epic's footprint covers nearly 2/3 of U.S. patients, the company has achieved a kind of de facto EHR integration. However, it's never been a wise approach in the hospital IT market to put "all of your eggs in one basket." Such a strategy gives too much power to one company and also sets the stage for more frequent EHR crashes across entire health systems (see: Sutter Health System EHR Crash Reported by Nursing Union). Exacerbating this problem is the fact that news about EHR crashes tends to be downplayed by EHR vendors and hospitals executives alike, compounding the criticality of the problem.
In my opinion, the solution to EHR interoperability does not rest with any proprietary vendor solution despite any the puffery used to describe it. The problem is complex but is dependent in part in the enforcement of health IT interoperability standards across all care settings and facilities (see: Top 5 Challenges to Achieving Healthcare Interoperability). Another element in the solution is the adoption of a universal health identifier for patients (see: The Quest for a Fail-Safe Patient Identification Solution in the U.S.). This will require a continuing and coordinated effort on the part of the federal government to robust health policy which will never happen with the current administration. Therefore, the efforts of Epic to achieve interoperabiliity across its installed client base are appropriate. This is the best that we can hope for at the present time.
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