Electronic Health Record’s (EHR’s) Lack of Interoperability


Epic, a privately-held healthcare software company

Have you ever noticed when you open a web page at the top there is often a link to the top five EHR providers?

According to the Office of the National Coordinator for Health Information Technology, there are over 2,098 modular and complete EHR systems for ambulatory and inpatient care.

A key provision of the American Recovery and Reinvestment Act (ARRA) was that as of January 1, 2014 all public and private eligible healthcare providers must have demonstrated “meaningful use” of EHR’s in order to maintain their existing Medicare and Medicaid rates.

But according to Louis Goodman and Tim Norbeck the problem with EHR’s as reported in Forbes on May 26, 2014 is that “hundreds of different systems exist but none of them are interoperable. One huge system called EPIC has different versions of the same EHR but they are not interoperable.”

In August 2014, Epic hired a Washington lobbying firm, Card & Associates to counter growing congressional criticism of it’s perceived lack of interoperability within itself and other systems. Bradford Card, CEO, is the brother of Andrew Card, President George W. Bush’s former Chief of Staff.

(A competing system is AthenaHealth, founded by Jonathan Bush, nephew of former president George H. W. Bush.)

Zina Moukheibur a Forbes contributor, wrote on April 18, 2012 that Epic had revenue of two billion one hundred million dollars in 2001 and that founder and CEO Judith Faulkner has a net worth of one billion seven hundred million.

The reason for engaging Card & Associates was presumably, according to Modern Healthcare, to address criticism singled out at Epic by U.S. Rep. Phil Gingrey (R-Ga.) at a House Energy and Commerce Committee hearing in July. Congressman Gingrey is a physician, who cited a RAND Corp. report asserting that Epic’s systems were “closed records.” Gingrey argued that the federal program providing incentive payments for healthcare providers to install EHR’s was intended to promote interoperability. “Is the government getting its money’s worth?” he asked. “It may be time for the committee to take a closer look at the practices of vendor companies in this space, given the possibility that fraud may be perpetrated on the American taxpayer.”

As reported earlier, according to a HealthAffairsBlog, “No other industry, to our knowledge has been under a universal mandate to adopt a new technology before its fully understood and before the technology has reached the level of usability that is acceptable to its core users.”

Here are two examples of the lack of interoperability.

According to Julie Creswell in a September 30, 2014 article in the New York Times, “almost 18 months ago after an Epic system was installed at UnityPoint Health-St. Luke’s Hospital in Sioux City, Iowa physicians there still cannot transmit patient care documents to doctors two miles away at Mercy Medical Center, which uses another major player in the field.”

Dr. William C. Rich, a member of a nine person opthalmology practice in Northern Virginia and Medical Director of Health Policy for the American Academy of Opthalmology is quoted as saying that “we spent half a million dollars on an Electronic Records System about three years ago and I’m faxing all day long. I can’t send anything electronically over it.”

Leave a Reply