Interoperability Crisis: The 1 Thing Doctors Hate Most About Electronic Health Records

In a recent study by KLAS Arch Collaborative researchers, over 500,000 clinicians were asked about their experiences with electronic health record (EHR) interoperability. The results were staggering, with external integration being reported as the worst part of their EHR user experience. In fact, it was the most-requested fix by physicians.

The researchers analyzed feedback from doctors and nurses at over 300 healthcare organizations, examining end-user satisfaction with external integration, needed improvements to how clinicians receive external patient data, and best practices from high-performing healthcare organizations.

One of the most striking findings was that 47% of clinicians reported that they could not easily access patient information from outside organizations through their EHRs. Additionally, 47% of clinicians said that they often had to filter through duplicated data, and that external data lacked accuracy, relevance, and accessibility.

A nurse interviewed for the study highlighted the importance of accurate and interoperable EHR data, saying, "EHRs can interpret information for things like immunizations differently, so if we are not careful, we can incorrectly document that a patient has received a vaccine."

Government data-sharing standards were also found to be inadequate, with EHR vendors not consistently facilitating needed data sharing. This lack of interoperability can lead to frustration and burnout among clinicians, as well as negatively impact patient care.

The study identified best practices from top-performing healthcare organizations, including establishing an interoperability governance committee, appointing dedicated resources, and coordinating with core sharing partners. A chief medical information officer (CMIO) recommended starting small by sharing data with regional health systems, saying, "It can be overwhelming to share data with the entire country, but in a region, there are usually 10-20 health systems that are responsible for over 90% of shared patient data."

KLAS researchers also emphasized the importance of involving EHR vendors in establishing data sharing settings and training clinicians on how to find outside information. The study found that clinicians who felt well-trained to leverage outside data were more likely to report that their EHR had expected external integration.

This finding is part of a larger trend of EHR dissatisfaction among clinicians. A previous KLAS study found that while nurse EHR satisfaction declined during the pandemic, physician EHR satisfaction varied by specialty. More recently, a 20-month study on post-pandemic burnout found that healthcare systems that addressed daily EHR irritants could reduce clinician burnout.

KLAS researchers emphasize that EHR efficiency is crucial in reducing clinician burnout. "Regarding EHR efficiency, physicians (and some nurses) report they are increasingly doing more work with fewer resources," the researchers said. "If organizations are unable to hire more staff to distribute the workload, they can instead ensure clinicians receive ample EHR education and that their workflows are optimized."

In conclusion, the study highlights the critical need for improved EHR interoperability and data sharing. By implementing best practices and training clinicians on outside data, healthcare organizations can improve EHR satisfaction and reduce burnout. As one CMIO said, "Far too much responsibility is placed on healthcare organizations to wrangle what is a hugely complicated problem of data mapping." It is time for the industry to come together to address this critical issue and improve the overall EHR experience for clinicians.