Quantitating and assessing interoperability between electronic health records
Open Access
- 7 January 2022
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of the American Medical Informatics Association
- Vol. 29 (5), 753-760
- https://doi.org/10.1093/jamia/ocab289
Abstract
Electronic health records (EHRs) contain a large quantity of machine-readable data. However, institutions choose different EHR vendors, and the same product may be implemented differently at different sites. Our goal was to quantify the interoperability of real-world EHR implementations with respect to clinically relevant structured data. We analyzed de-identified and aggregated data from 68 oncology sites that implemented 1 of 5 EHR vendor products. Using 6 medications and 6 laboratory tests for which well-accepted standards exist, we calculated inter- and intra-EHR vendor interoperability scores. The mean intra-EHR vendor interoperability score was 0.68 as compared to a mean of 0.22 for inter-system interoperability, when weighted by number of systems of each type, and 0.57 and 0.20 when not weighting by number of systems of each type. In contrast to data elements required for successful billing, clinically relevant data elements are rarely standardized, even though applicable standards exist. We chose a representative sample of laboratory tests and medications for oncology practices, but our set of data elements should be seen as an example, rather than a definitive list. We defined and demonstrated a quantitative measure of interoperability between site EHR systems and within/between implemented vendor systems. Two sites that share the same vendor are, on average, more interoperable. However, even for implementation of the same EHR product, interoperability is not guaranteed. Our results can inform institutional EHR selection, analysis, and optimization for interoperability.Funding Information
- National Center for Advancing Translational Sciences (UL1TR000371, U01TR002393)
- Cancer Prevention and Research Institute of Texas (RP170668)
- ASCO CancerLinQ
- Reynolds and Reynolds Professorship in Clinical Informatics
This publication has 6 references indexed in Scilit:
- Development of CancerLinQ, a Health Information Learning Platform From Multiple Electronic Health Record Systems to Support Improved Quality of CareJCO Clinical Cancer Informatics, 2020
- Quantifying the competitiveness of the electronic health record market and its implications for interoperabilityInternational Journal of Medical Informatics, 2019
- Quantifying interoperability: An analysis of oncology practice electronic health record data variability.Journal of Clinical Oncology, 2019
- The HITECH Era in RetrospectThe New England Journal of Medicine, 2017
- The Value Of Health Care Information Exchange And InteroperabilityHealth Affairs, 2005
- LOINC, a Universal Standard for Identifying Laboratory Observations: A 5-Year UpdateClinical Chemistry, 2003