Few U.S. hospitals can fully share electronic medical records

(Reuters Health) - Less than one in three U.S. hospitals can find, send, and receive electronic medical records for patients who receive care somewhere else, a new study suggests.

Just 30 percent of hospitals had achieved so-called interoperability as of 2015, the study found. While that’s slight improvement over the previous year, when 25 percent met this goal, it shows hospitals still have a long way to go, researchers report in Health Affairs.

“What this means is there is potentially a significant amount of waste and inefficiency in hospitals,” said lead study author Jay Holmgren of Harvard Business School in Boston.

Without access to patient records, doctors might re-order tests that have already been done somewhere else, or make treatment decisions without a full picture of any allergies or underlying medical conditions.

“And, without a system for getting electronic patient data to clinicians, the responsibility falls on patients and their families, who often resort to bringing printouts of records from one hospital to another,” Holmgren said by email. “It just adds to the burden of being sick.”

For the study, researchers examined survey data from hospitals that belong to the American Hospital Association (AHA).

The study found that hospitals across the country have focused primarily on moving electronic health records from one institution to another, rather than on integrating relevant subsets of information - for example, clinical notes, lab tests and other patient information - in ways that would allow clinicians to easily learn what they need to know without having to read through a patient’s entire record.

While 43 percent of hospitals reported that outside patient information was available electronically when necessary in 2015, more than one-third reported that they rarely or never used it.

The most common barrier these hospitals reported to using outside information was that their clinicians could not see it embedded into their own system’s electronic health record.

Just 19 percent of hospitals said they often used data from outside providers.

“Sharing electronic information between hospitals has been poor for many years,” said Dean Sittig, a biomedical informatics researcher at the University of Texas Health Science Center at Houston who wasn’t involved in the study.

“At first, we blamed it on lack of data in electronic form, and now that the vast majority of hospitals have electronic health records and therefore the data is in electronic form, we need another excuse,” Sittig said by email.

“The findings in this article say that for the most part, hospitals are still not sharing data and even fewer are actually integrating that shared information into their electronic health records,” Sittig added.

To compensate, patients often obtain copies of records that they deliver in person to an outside provider or request that they be sent, said Ann Kutney-Lee, a researcher at the University of Pennsylvania School of Nursing in Philadelphia who wasn’t involved in the study.

Patients also have some options to manage their own records electronically.

“Patients can create their own online Personal Health Record (PHR) where they can store, manage, and share health information all in a single location - although all of the data would initially need to be collected by the patient and then manually uploaded,” Kutney-Lee said by email. “Most of these websites are free and are accessible by computer or smartphone.”

Increasing numbers of health care providers and hospitals are also offering patients access to online portals that contain all lab work, health histories, and test results performed by that provider, hospital, or healthcare system.

“Although many of these portals do not yet link with outside providers, patients could enter this information into a personal health record themselves,” Kutney-Lee said.

SOURCE: Health Affairs, online October 2, 2017.