In seeking the opinions of more than 500,000 clinicians on electronic health record interoperability, KLAS Arch Collaborative researchers learned that external integration was reported to be the worst part of their EHR user experiences, and "the most-requested physician fix." 

WHY IT MATTERS

Examining feedback from doctors and nurses at more than 300 healthcare organizations, the researchers looked at end user satisfaction with external integration, needed improvements to the ways clinicians receive external patient data and best practices from high-performing healthcare organizations.

In asking 33,000 clinicians specifically about their experiences using patient data from outside organizations, 47% said that they could not access patient information from outside organizations through their EHRs easily, KLAS said in the new report, EHR Interoperability. 

They often have to filter through duplicated data, 47% of the clinicians also said. The external data lacks accuracy, relevance and accessibility.

"EHRs can interpret information for things like immunizations differently, so if we are not careful, we can incorrectly document that a patient has received a vaccine," one nurse told KLAS.

Government data-sharing standards are also inadequate, according to some healthcare organizations, the researcher said. While most EHR vendors advanced connectivity with national record exchanges, EHR vendors do not consistently facilitate needed data sharing.

"Healthcare organizations often feel unempowered to improve interoperability for their clinicians and patients," the researchers said.

During the study, executives from top-performing healthcare organizations revealed best practices, and recommended that their peers start with a commitment to sharing data by establishing an interoperability governance committee, appointing dedicated resources and then coordinating with core sharing partners.

"It can be overwhelming to share data with the entire country, but in a region, there are usually 10-20 health systems that are responsible for over 90% of shared patient data," said one chief medical information officer. "Sharing data with those health systems is doable." 

The third step is defining what successful sharing looks like, which "enables deep data extraction," the KLAS researchers said in the report. 

Involving EHR vendors as much as possible in establishing data sharing settings is critical, they added. 

Another CMIO told KLAS that industry standards are too broad, and "Far too much responsibility is placed on healthcare organizations to wrangle what is a hugely complicated problem of data mapping," they said. 

Training clinicians on how to find outside information, leading to EHR satisfaction, is something organizations should take on to ensure clinicians find mapped data.

"Of clinicians who feel they are well trained to leverage outside data, 72% report their EHR has expected external integration; of clinicians who don’t feel they are well trained in this regard, only 26% agree that their EHR has expected external integration," researchers said.

THE LARGER TREND

Two years ago KLAS researchers found that, while nurse EHR satisfaction slid during the pandemic, physician EHR satisfaction varied by specialty.

Then, a more recent 20-month study on post-pandemic burnout released in January, indicated that the healthcare systems that managed to fix daily EHR irritants could reduce clinician burnout.

After improving staffing and better aligning leadership to the clinical staff's concerns, the health systems could focus on solving inefficiencies that add to their administrative frustrations, the researchers said in the previous trend study.

"Regarding EHR efficiency, physicians (and some nurses) report they are increasingly doing more work with fewer resources," said KLAS researchers. 

"If organizations are unable to hire more staff to distribute the workload, they can instead ensure clinicians receive ample EHR education and that their workflows are optimized."

ON THE RECORD

"Regardless of EHR vendor, interoperability is a major pain point for clinicians amid an already painful EHR experience," KLAS researchers said in the new report.

"Among the 11 metrics used to calculate the Net EHR Experience Survey, clinicians are least satisfied with external integration – only 44% of respondents agree their EHR provides expected integration with outside organizations."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.