Lancaster Physician Spring 2017 - 29

spring 2017

Where are we with EHR Interoperability?

Even different institutions within the same
health system may lack Electronic Health
Records Interoperability (EHRI), a fact that
Dr. Joanna Brelvi, Associate Chief Medical
Information Officer for WellSpan Health,
understands too well.
Within WellSpan's six hospitals, medical
practices, and other partners, there are five
major EHR systems and several small ones,
making it extremely difficult to obtain a level
of interoperability.
"It's a patchwork of systems," Brelvi said.
"Some of the systems are pretty well intertwined, but others don't communicate at all."
The situation, she said, is limiting.
"Imagine if your cell phone could only call
other phones with the same hardware and
software," Brelvi said. "That's how it is."
To alleviate the problem, WellSpan is poised
to convert to a single EHR system, beginning
in May.
"That is a huge step for us," Brelvi said.
The idea to have patient information
recorded electronically instead of on paper
goes way back to the 1960s, when a Vermont

physician and teacher named Lawrence Weed
introduced the concept of the Problem-Oriented Medical Record.
Weed believed that, given the numerous
problems and challenges physicians confronted
each day, they should have a more structured
and scientific method of addressing them.
It was Weed's assertion that, instead of each
physician recording only the diagnoses and
treatments that he or she provided, there should
be a record generated that would enable a third
party to independently confirm the diagnosis.
The concept was lauded as a major innovation, but it had trouble getting any traction in a
practical sense. In 1991, however, the Institute
of Medicine, a well-respected think tank,
recommended that by 2000 every physician
should be employing computers with a goal
of improving patient care.

marketing to. This included specialty-specific,
hospital-based, outpatient-based, and surgical
center-based EHRs, to name a few. While they
helped transition from paper to electronic,
they still didn't allow the data to be easily
shared outside the walls of the institution
using that EHR.
Fortunately, a need for interoperability
was recognized, and efforts are underway to
improve communication between systems.
"The standard has been changed within the
past 10 years so that they at least speak the
same language," Martin explained.
Being able to access a patient's health records,
both within and outside of a health system,
is proven to improve patient care, increase
efficiency, and cut costs. And yet, it has been
slow to come.

By that time, companies had recognized
a largely untapped potential and begun
creating software systems to manage health
records electronically.

To date, the only way a physician within
the WellSpan system would know if a patient
had been treated in a non-system emergency
department is if the patient said so.

The problem, according to Martin, is that
each software program operated independently,
with no way of linking to another system.
Literally hundreds of EHRs popped up to
fill the needs of the target group they were

"If the same person goes to emergency
rooms in Ephrata, at Heart of Lancaster, and
at Lancaster General, the only way doctors

LANCASTER

29

PHYSICIAN

Continued on page 30



Table of Contents for the Digital Edition of Lancaster Physician Spring 2017

Lancaster Physician Spring 2017 - 1
Lancaster Physician Spring 2017 - 2
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