September 21, 2021

Creating Meaningful Interoperability for Patient Healthcare Records

Enhancing EHR connectivity, accessibility and ease of use

by Adam Plotts, Strategic Director, Clinical Technology for Labcorp

My experience in the electronic health record (EHR) space ranges from implementing EHR technology into physician practices to building reporting solutions in support of CMS "meaningful use." This program has been the main source for physicians adopting EHRs and creating and sharing structured, reportable data. Since then, our industry has made massive investments in interoperability solutions, and we have seen many initiatives attempting to connect health systems. However, as I engage with healthcare providers and executives, I see a continued challenge in defining how we deliver data and achieve meaningful interoperability.  

Applying Interoperability to Healthcare

A perfect example of successful interoperability is an everyday banking function. We can visit an ATM anywhere in the U.S., insert our bank card, enter our PIN and get cash. The system understands our banking information and provides access to our funds quickly and easily wherever we are.  

When I think about healthcare interoperability, the key concepts that come to mind are connectivity, accessibility and ease of use.

Our field demands an increased focus on developing clinical content and decision support tools to identify high-risk patients and facilitate treatment plans – at the point of care. Examples include infographics to highlight disease severity plus patient-specific interpretations of results in the context of the patient's condition. Longitudinal views of patient data can help the clinician evaluate trends in the patient's condition over time and their response to treatments, as well as identify care gaps.

Providing Collaborative, Timely Insights

Within healthcare, the utopia for interoperability is to deliver the same experience a patient enjoys with banking. A patient should be able to go anywhere in the nation and have a clinician access their full medical record as part of a standard workflow. The provider shouldn't have to access or understand a new platform; the information should be readily available in a format the provider understands.

Currently, most of the interoperability solutions we see in the market require EHR users to take extra steps to retrieve additional data residing outside of their EHR. Whether it is launching an app that has already aggregated the data or using a solution that can ping trusted health networks for additional patient information, the process remains inefficient and incomplete. In a perfect world, complete information would be part of the patient's medical record, accessed wherever the patient is—visiting a walk-in clinic, seeing a specialist or while traveling—without extra clicks or effort.

How far are we from EHR interoperability utopia? There is movement, as interoperability based on fast healthcare interoperability resources (FHIR) is gaining momentum. We see the top EHR vendors delivering FHIR-based platforms and third-party interoperability platforms inching closer to the utopia for which we strive. In a perfect world, when a provider accesses a patient's record, the system automatically pings trusted networks, imports their data and then auto-populates records into the patient's chart. From a technology perspective, our industry is making progress, but it's one thing to build the technology and another matter to see it validated, adopted and widely implemented.  

Understanding the Challenges  

We must connect the patients, the providers and the various health systems. This critical need is underscored by patients experiencing chronic, complex conditions and needing to visit their primary care physician, multiple specialists and different clinics. All parties need access to current data and insights. 

As an industry, we're at an inflection point on this key issue of interoperability because the need is strong, and the potential is great.

The main challenge is the way technology brings outside patient data into the provider's workflow. Currently, the outside data a provider receives aren't actionable and are merely presented as a document or an application that they must launch from their EHR. While the provider can see the patient's history based on data from specific sources, the system doesn't stitch the data together within the existing EHR to provide one comprehensive picture. Instead, the provider usually needs to navigate multiple applications to get the most comprehensive view of the patient's history. While these applications contain clinically meaningful data, this is a time-intensive process for the physician who is already facing work and information overload.  

Providers require a solution that meets them in their workflow, showing all meaningful information through a single, integrated lens for each patient.

Beyond the challenges of creating a connected experience for the patient and provider, the challenge is further exacerbated by siloed initiatives across the country. While local and state-based health information exchanges (HIEs) have made tremendous progress in creating comprehensive records of the patient's local activity, they are still limited by where the patient may be seen across the U.S. With collaborations such as Carequality, CommonWell and the Strategic Health Information Exchange Collaborative (SHIEC), there is hope that the silos are collapsing. However, there will come the point when health systems need to decide which solution or collaborative works best for their organization, and the result will not meet the utopia of interoperability.  

Leveraging Labcorp  

Because of the pandemic, Labcorp is increasingly known not only for laboratory diagnostics but also for data delivery. We play a significant role in the path to interoperability because of our ability to centralize every lab test completed at Labcorp facilities across the nation and deliver a single, longitudinal lab history to the provider or patient. A provider can log in to our portal, look up a patient and see all their test results, regardless of which provider ordered the tests or which Labcorp facility performed those tests. While this solution meets providers' workflow requirements, it is not our intention to be considered another siloed system.  

Labcorp can support EHR interoperability evolution by delivering information in a more meaningful way, ensuring that laboratory data are readily available to providers within their workflow and complementing advances in EHR technology.

Labcorp is passionate about delivering the right laboratory information, to the right clinician, at the right time, and we understand our responsibility in playing a role to support the continuum of patient care. However, we can only accomplish this goal with the involvement of our customers.