Sharing EHR–not an easy task

According to a survey by the nonprofit Physicians Foundation cited in a recent edition of the Charlotte Observer, approximately three quarters of the doctors in North Carolina are using electronic health records (EHR). 

These adoptions can be attributed to the Centers for Medicare and Medicaid Services (CMS) EHR “Meaningful Use” incentive program that was included in the American Recovery and Reinvestment Act in 2009. Using a carrot and stick approach backed by incentives and penalties, CMS expects to have physicians who receive Medicare and Medicaid reimbursement using a certified EHR after 2016.  More importantly, physician adopters must use EHRs in a meaningful way—better access to information, better health outcomes, and an increase in population health. 

However, due to the number of certified EHR systems available, proper implementation and use can be fragmented, with many systems still unable to talk to each other. As described in the report, this was a common complaint of many physicians who could not get their EHR systems to share patient information across organizational boundaries.

Sharing health information across different EHR systems is harder than it seems, and will require technical infrastructure, common terminologies and information standards, open minded governance, and congruent reimbursement mechanisms.

Once physicians have successfully implemented an EHR system, they may join a Health Information Exchange, which is a type of organization specializing in exchanging data and information across different health information systems. Coastal Connect Health Information Exchange (CCHIE) in the Wilmington area is an example of such a regional organization. NC Health Information Exchange (NCHIE) is the state level non-profit organization designed to provide a set of secure and scalable services that allow health information to be accessed, exchanged, and analyzed throughout the state.

Seamless health information exchange will be the foundation for coordinated care in emerging practice models such as Patient Centered Medical Home (PCMH) or Accountable Care Organizations (ACO).

Xiaoming Zeng, MD, Ph.D.
Associate Professor and Chair
Department of Health Services and Information Management