The most straightforward definition of interoperability we have heard so far is from David Kendrick, CEO of MyHealth Access Network in Oklahoma, “Every patient deserves to have their complete, longitudinal medical record available wherever and whenever decisions are made about their health.” By this measure, interoperability is still unusual in most sectors of the U.S. healthcare system. The ‘lack of interoperability’ between EHRs has become a clarion call for those dissatisfied with EHRs in general as well as with the fruits of EHR certification and the MU program.
More troubling, interoperability ills are now being cited as a reason to impose civil penalties for ‘information blocking.’ ONC’s report to Congress on information blocking in healthcare acknowledged that information blocking is widespread even though its exact scope remains a mystery. The report admits that the causes are more complicated than the simple competitive concerns of EHR vendors and HCOs. Vendor gaming of pricing and features is real. Providers resist sharing data with real or perceived competitors. To borrow a phrase from Exxon’s CEO and apply it to healthcare – most HCOs choose not to lose patients on purpose. The report’s key takeaway is that business practices, rather than technology, are a primary driver of data hoarding by different healthcare stakeholders.