Healthcare Technology Featured Article

January 09, 2023

3 Issues That Hinder EHR Interoperability and How to Solve Them

Although EHR solutions have been in the spotlight for over a decade, they are still riddled with some persistent interoperability issues. The importance of EHR interoperability has skyrocketed during the pandemic. Exchanging EHR data allows for not only more efficient patient treatment but also for faster understanding of the pandemic in a particular patient population. Hence, healthcare experts have intensified their efforts in ensuring interoperability. According to a 2022 report from Statista, one-fifth of healthcare leaders worldwide aim to solve the interoperability problem in one way or another.

So what are these problems and why they are so hard to resolve? Let's look into the matter.

Why is EHR interoperability so difficult to achieve?

First and foremost, we need to make clear problems with EHR interoperability do not arise from the laziness of medical personnel. There are some objective factors in the medical facility’s operations that slow down working with EHR, for example:

  1. Insufficient skills of clinical staff. Working with EHR in terms of interoperability is a separate type of activity that is not directly related to the professional responsibilities of medical workers.
  2. Lack of industry standards that unify data formats. Unfortunately, exchanging health-related data is not a simple matter. Because of disparate data formats across facilities, in most cases their value is restricted to their owner only.
  3. The abundance of EHR solutions. EHR implementation depends on the provider’s size, budget, and scope of services. Interestingly, the same provider can use several EHR systems across the facility, for example, general hospitals that offer medical services in several specialties. Besides, a hospital can employ EHR solutions from different vendors, and they don’t always “communicate” well.

Key solutions to the EHR interoperability problem

An umbrella EHR

To avoid complications with sensitive information sharing, some hospitals opt for deploying the same EHR system across all their locations. That was the case with Piedmont HealthCare, a large network from Atlanta, Georgia. They united their five new members under the umbrella of the Epic system. This helped reach seamless interoperability across the network clinics.

While the efficiency of the approach is undoubted, the cost of the matter may be high. Hence, such generous investments are affordable only to large networks. So let’s explore more budget-friendly options down below.

Staff training

As we know, EHR training is a standard practice offered either by vendors or external specialists. To promote EHR interoperability, you can set up a dedicated training session to explain the approach to interoperability the clinic selected to medical personnel. They should also know interoperability workflows and the key partners with which the hospital works.

Data standardization

Today’s healthcare data is abundant. It covers not only EHR information but also data sets generated by diverse medical and consumer devices. Nevertheless, the value of this data is small, as it stays within a single healthcare system. Besides, such systems may vary across a provider. On average, a provider employs 16 disparate EHR implementations. Besides, each system has its own way of gathering and storing health-related data, which virtually blocks interoperability. Developing unified data standards can change the situation.

Having acknowledged the need for standardization in the industry, policymakers and regulatory bodies started their work on data standards. In June 2022, ONC introduced USCDI version 3, a standardized set of data classes relevant for nationwide interoperability. Nevertheless, that effort is the first step to ensuring all-country interoperability, but healthcare professionals and patients need data sharing here and now.

At the moment, you can turn to data exchange options at your disposal, such as FHIR. According to the Trends in EHR interoperability report by KLAS and CHIME, 24% of providers use standards for EHR data exchange. However, if you choose this option, be aware that this standard does not provide interoperability by default. To enable data sharing with FHIR, you need to create compatible environments aligned with this standard. The thing is, the standard offers several implementations that may lack smooth interaction.

So, EHR interoperability may be out of reach even with the industry standard. Fortunately, there’s yet another set of options for ensuring cross-provider data sharing  – workarounds.


For a swifter solution to the interoperability challenge, you can follow one of the approaches described below.

  1. Adopting the cloud. A cloud-based EHR solution can help improve sensitive data security, patient engagement, and the interoperability of electronic records. At the same time, moving to the cloud doesn’t make your EHR solution interoperable automatically. To ensure interoperability, you will have to properly configure access for partners and other clinics in the network, or create a separate cloud for data sharing. To prevent errors and difficulties, you can hire a reputable vendor.
  2. A health information exchange (HIE). HIEs are secure solutions covering clinics at the state, cross-state, and national levels that enable providers to share patient health records without difficulties. During the pandemic, many HIEs emerged as cloud solutions. In this case, ensuring interoperability does not require complex integrations across disparate medical systems. To join an HIE, you need to check what HIE providers are available in your state or region. Then you need to select an HIE provider relying on their maturity level. Additionally, you need to find out how the exchange works and if your EHR system supports those technologies.
  3. Unified EHRs. Some providers team up with neighboring medical centers to ensure interoperability. For example, St. Dominic Hospital from Jackson, Mississippi, granted access to their Epic EMR to a neighboring medical center. Today, the neighbors collaborate in the treatment of stroke, cardiovascular diseases, and more. The unified EHR system will help clinicians improve treatment coordination and planning, as well as financial processes and billing.

Summing up

As we have understood, ensuring EHR interoperability is not an easy task. Factors not directly related to end users may hamper it, including:

  • The differences in implemented EHRs
  • The lack of skills for working with an interoperable EHR among healthcare professionals
  • Different data formats in which providers store health data

Fortunately, there are approaches to solving these problems efficiently. To improve EHR data sharing without huge spendings, you can:

  • Provide dedicated training to medical specialists
  • Join an HIE
  • Create a unified EHR with some neighboring provider

It’s also vital to remember that ensuring EHR interoperability may require professional assistance. A reputable vendor can help you choose an interoperability solution that suits your needs best.

According to the KLAS and CHIME report mentioned above, many healthcare providers have fully acknowledged the importance of interoperability. Perhaps with further advances in ensuring interoperability, the US healthcare system will finally be able to achieve its main goal – offering tailored health care right when it is needed.

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