It’s like finally getting a smartphone but only being able to call people in your own family.
 
Seven years after the government incented hospitals to replace their paper medical record systems with electronic health record systems, the hospital EHR adoption rate is closing in on 100 percent. But what hospitals do with those EHRs systems continues to be limited to what happens within their four walls.
 
That’s according to two reports released this week by HHS’ Office of the National Coordinator for Health Information Technology. The first report tracked hospital EHR adoption rates over time, and the second report looked at the interoperability of those EHR systems.
 
In 2008, just 9.4 percent of the nation’s hospitals had a “basic” EHR system in place at their facilities. HHS defines a “basic” EHR system as one that can electronically capture patients’ clinical information, allow providers to enter in laboratory and other diagnostic test results, allow providers to view all test results and clinical notes and provide clinical decision support like treatment guidelines and drug alerts.
 
A year later, Congress passed the American Recovery and Reinvestment Act in 2009. Provisions of the law offered financial subsidies to hospitals and doctors to adopt and use EHRs. By 2015, the percentage of hospitals with a basic EHR system had climbed to 83.8 percent, according to the first ONC report.
 
Over that time, Minnesota hospitals stayed ahead of the curve. In 2008, 17 percent of the state’s hospitals were using a basic EHR system. By 2015, that percentage had jumped to 88 percent.
 
That’s the good news, especially if you’re a patient or employee who receives care only at one hospital and only from physicians affiliated with that hospital. But if you’re a patient or employee who receives care from multiple unaffiliated hospitals and by physicians in different medical practices, the chances of your clinical information making it from one place to another when you’re sick is only about one in four.
 
According to the ONC’s second report, just 26 percent of hospitals are interoperable. That means their EHR systems can perform the four tasks that define interoperability. The four are electronically finding, sending, receiving and integrating patient health information from providers outside of a hospital’s own health system. That’s up from 23 percent in 2014 but far from where healthcare needs to go in order to coordinate the care of mobile patients who may choose different providers based on price, quality, safety or value.   
 
“There is still significant progress to be made to improve the use of exchanged information and to address barriers to interoperability,” the report concluded.
 
The biggest barrier, according to the hospitals surveyed for the report, was the lack of the technical capacity of another provider’s EHR system to receive patient data.

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