The Benefits and Challenges of EHR Interoperability in Healthcare

A mind-boggling statistic to those outside the healthcare industry is that, as recently as 2012, the fax machine was still a primary means of communication for an estimated 63% of physicians. But with more and more healthcare professionals switching to electronic health records (EHRs), this office dinosaur is finally going extinct in today’s digital age – right?

Well, maybe. Despite massive investment and effort in technology and health information systems, there’s still a long way to go to reap the full promised benefits of EHRs. And the reality is that faxing and mailing patient records remain common among physicians. This blog discusses the challenges along the way alongside the benefits of EHR interoperability.

What is Electronic Health Record?

Picture having all of your medical information right at your fingertips. That’s the power of an EHR – a digital version of your paper chart accessible to authorized users in real-time. But it’s not just limited to your clinic visits; EHRs can contain a comprehensive view of your care, including past diagnoses, medications, treatment plans, immunizations, and more. 

EHR integrations help to automate and simplify workflows, making it easier for providers to focus on what matters the most. Plus, with evidence-based tools available to healthcare professionals, they can make more informed decisions about your care. 

The Difference Between EMRs and EHRs

  • Like EHRs, electronic medical records (EMRs) are the digital successors to those thick stacks of patient charts that clinics used to keep. Not only do EMRs provide a history of medical treatments, but these records also offer perks that traditional paper records can’t match. For instance, EMRs help healthcare providers keep tabs on EHR data, patient appointments, and specific health indicators like blood pressure or vaccination histories. However, despite the advantages, EMRs fall short when it comes to information sharing. In many cases, patient records have to be physically printed out and delivered by mail to specialists and other care team members, making EMRs not much better than their paper predecessors.
  • EHRs entail all those advantages—and more, without the downsides. Designed to be shared beyond the health organization that gathers the information, EHRs connect data from all facets of a patient’s care. The information travels with the patient—to the hospital, the specialist, the nursing home, or even across state lines. HIMSS Analytics indicated that the main distinction between the record types lies in the ability to transfer medical information between stakeholders effortlessly and make the information available throughout the various modalities of care a patient engages. And that’s what makes all the difference, as healthcare data becomes more powerful when shared securely.

What is EHR Interoperability?

The world of healthcare runs on data, and EHR interoperability is the key to maximizing that data’s potential. Interoperability allows multiple EHR systems to connect and exchange patient information securely and seamlessly. 

Among the various healthcare interface standards in place, Health Level Seven (HL7v2 or v3) is the most widely used, which relies on the Common Clinical Data Set (CCDS). The beauty of this standard is that healthcare providers can exchange data regardless of their software platforms without requiring any special coding skills. Connecting EHRs across different hospitals and facilities means there’s no valuable information left hidden. 

It’s all about ensuring everyone is on the same page and that researchers have access to the latest health data to further their understanding of the complexities of diseases. 

The Journey Toward EHR Interoperability

The government’s efforts to digitize patient records nationwide through electronic health information exchange began with the 2009 American Recovery and Reinvestment Act. And with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, more than $35 billion in incentives have been allocated to promote the adoption and use of EHRs by eligible hospitals and healthcare professionals. This ambitious plan aimed to improve healthcare delivery countrywide, bringing a more modern approach to record-keeping and allowing for greater efficiency moving forward.

HITECH’s proposed five-year plan, introduced in 2011, aimed to improve patient care quality, safety, and efficiency by requiring healthcare providers to demonstrate “meaningful use” of EHR technology. The plan consisted of 3 phases, each with its own specific set of measures that providers had to adopt. The Centers for Medicare and Medicaid Services (CMS) established these phases to ensure a seamless transition towards improved healthcare technology.

A decade later, despite the implementation of EHRs following the passage, questions linger about the effectiveness of the legislation. Yes, EHR adoption has been at a high rate since the law, with 96% of hospitals having a federally certified EHR program, but there are still hurdles to overcome. One of the biggest challenges is getting all the stakeholders to work together collaboratively. Add to that a host of complicated regulations, and it’s no wonder medical professionals have been suffering from burnout.

On the plus side, the increase in EHR adoption since 2008 is ninefold. And a certified EHR system is in place in almost 80% of office-based physicians. 

However, HITECH’s other key goal is to attain interoperability across all care settings. And this task has proved to be more daunting than expected. After the first 5 years, only 12% of physicians succeeded in completing stage 2 of meaningful use, and only 6% of providers could transfer patient information to others with a different EHR system.

Critics of the HITECH Act argued that misaligned incentives are partly to blame for the lack of interoperability. One of the main criticisms is that HITECH’s incentives focus more on EHR adoption than health information exchange, resulting in EHR systems being designed and adopted without considering health information exchange, making interoperability difficult. 

While there are requirements for interoperability in stages 2 and 3 of meaningful use, many providers couldn’t justify the costly fees associated with implementing interoperability. Additionally, vendors didn’t have enough incentives to render their systems easily interoperable in the first place.

Why is Interoperability so Challenging? 

Lack of Homogeneity 

The diverse and scattered nature of data across major EHR systems is no minor headache for clinicians. 

Having to comb through numerous sources to locate relevant information can be a time-consuming and frustrating process. The lack of a cohesive data model in major EHR systems complicates the work of healthcare professionals. But there is hope. By using a uniform network that automatically integrates data from different sources, clinicians can streamline their workflow and focus on providing patients with the best possible care.

Resistance to Data Sharing

Despite the importance of sharing healthcare data, some providers are reluctant to exchange their data. 

For example, hospitals and urgent care clinics may compete for patients and have little incentive to share patient data. Insurance companies are likewise resistant to sharing it with healthcare providers, albeit storing diverse patient data. Nevertheless, the ONC’s Cures Act Final Rule is pushing for change in the industry. By adopting standardized APIs, healthcare providers may access structured electronic health information from mobile applications. 

Failure to comply may result in fines and reports of data blocking. It’s time for the healthcare industry to prioritize patient care and make data more accessible across organizational boundaries. 

Patient Data Security

Keeping patient data secure can be challenging for EHR systems. To ensure that their information is transmitted safely and efficiently, providers must implement numerous safeguards, including complying with HIPAA Security Rule standards and other applicable guidelines. 

Healthcare organizations also need to prioritize encryption and decryption mechanisms for electronic protected health information (ePHI), all while ensuring secure transmission measures to prevent unauthorized access to patient information during transfer.


Another primary barrier is the financial costs of implementing EHR systems and interoperability solutions. Depending on whether web-based or server-based deployment is selected, upfront and yearly costs of implementation range from $15,000 to $70,000 per provider, according to the Michigan Center for Effective IT Adoption. On top of that, to be interoperable with other providers and organizations, EHR systems often need many customized interfaces. 

The ever-evolving landscape of the EHR market now has more affordable, cloud-based technology, yet many smaller practices still lack the technical expertise and resources to implement EHRs effectively. This discrepancy is a digital divide between large hospital systems and physician practices or small rural hospitals struggling both technologically and financially.

What Are the Benefits to Outweigh the Costs?

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Higher Efficiency

By breaking down the barriers between healthcare systems, EHR interoperability allows clinicians to access real-time patient data efficiently. The elimination of redundant information entry, as well as the facilitation of record retrieval and updating, can save a significant amount of time. This streamlines care delivery, increases productivity, and helps reduce preventable medical errors. Ultimately, interoperability improves healthcare delivery by increasing the number of individuals receiving timely and accurate care.

Better Patient Care

Efficient healthcare delivery depends heavily on convenient access to patient data. The ability to gather health information about patients can minimize repeat tests, prevent unintended treatment interactions, and avoid misunderstandings. Achieving interoperability is integral to this improvement, allowing seamless data sharing and more effective and informed decision-making. With access to an integrated data pool, providers are better equipped to deliver targeted care and improve patient outcomes. 

Improved Patient Experience

EHR interoperability can simplify everything, from reducing administrative hassle to promoting job satisfaction and improving patient experience. Smooth integration reduces paperwork, providing patients with more streamlined experiences. At consultation or follow-up, this level of integrated data access makes life easier for patients and staff. 

Higher Revenue

Not only does interoperability improve healthcare communication, but it can also increase revenue for healthcare facilities. 

By employing efficient population health management techniques, hospitals and providers are better equipped to participate in a value-based care reimbursement model (VBC) instead of traditional fee-for-service models. With VBC, healthcare facilities can reduce hospital readmissions, improve patient engagement, and ultimately lower costs. Prioritizing interoperability can also lead to acquiring and retaining patients more effectively, driving both growth and revenue for healthcare organizations.

Finding the Right Healthcare Interoperability & Healthcare Data Integration Partner

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Here’s how experts in healthcare interface technologies will help you navigate interoperability:

  • Clearly assess and outline your challenges.
  • Define your interoperability roadmap and goals, whether it’s connecting to one API or dozens of systems within a large provider network. The bigger the scope, the more variables among data exchange technologies and types. 
  • Identify technologies and exchange systems in place and establish a winning hybrid strategy to create data harmony.
  • Establish a confident technology and process path forward and timeline.
  • Do the work: Development, testing, QA, documentation, and support for your interoperability goals.

Need help with creating next-level EHR interoperability solutions? Choose KMS Healthcare as your interoperability partner. A team of experienced developers can revolutionize research, testing, integration, and delivery. Contact KMS to learn more about our positioning as a top provider of healthcare interoperability solutions. 

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