What almost everyone does seem to agree on is that progress toward interoperability up to this point has varied substantially across the healthcare industry. “Most of the big health system EHR vendors have basic interoperability capability in their current versions or coming soon," said Wheaton. He added that many pharmacy management systems don’t have those capabilities yet, making it hard to achieve full interoperability across the continuum of care.
The problem, he said, is the lack of economic and regulatory incentives. “CMS' rules apply mostly to hospital systems, and pharmacists don't fall under that umbrella."
Peinie Young, a director of Innovation Solutions at Fuse, said that community pharmacies have made great strides with e-prescribing and exchanging prescription-data, but that stakeholders are working to extend this trend toward allowing community pharmacies to exchange EHR data. She added that the Pharmacy Health Information Technology Collaborative is leading the push for interoperability in the pharmacy industry and is a great resource for forward-looking pharmacies.
However, most hospitals are also still struggling with interoperability—even when they do have CEHRT at their disposal, said Fuse data scientist Pamela Pallett. “Not all clinics have stellar EHR support, and communication between health ecosystems still needs improvement," she added.
For example, Pallett said, doctors providing treatment at a hospital emergency department would benefit from having patients' health and prescription histories immediately available. “But today, if that hospital is out-of-network for the patient—maybe they were traveling—this kind of access might not be possible."
In Pallett’s opinion, the proposed changes from CMS are a step in the right direction, especially because of their potential impact on costs. “If the cost of creating and implementing an interoperable system is greater than the financial benefit for an organization, then it will never take off."
New EHRs require training on the part of physicians and personnel, and that training can be time-consuming and expensive. And then there's the time clinicians spend on EHRs once they're up and running—the data entry and other administrative tasks that tend to pull them away from hands-on patient care.
“It's good to hear that CMS wants to reduce the burden hours," Pallet said. “Hopefully it will open more time for both training on these new systems and helping patients."