As 2019 comes to a close, the debate between potential 2020 Democratic presidential candidates regarding healthcare is heating up.
While each candidate has their own healthcare policy and ideas about what should change, and what should stay the same, one has touched on the EHR market specifically. Sen. Elizabeth Warren's plan would include an antitrust investigation into the EHR market, challenging the lack of interoperability and competition.
Most healthcare providers see interoperability as a significant challenge to providing the best possible patient care, and Ms. Warren doesn't think the large EHR companies have done enough to ensure vital patient information is passed efficiently between systems.
"Congress spent $36 billion to get every doctor in America using electronic health records, but we still do not have adequate digital information flow in health care – in part because two big companies make up about 85 percent of the market for medical records at big hospitals," she wrote in her transition plan for her first 100 days in office. "As they attempt to capture more of the market, these companies are making it harder for systems to communicate with each other. My administration will ramp up the enforcement against information blocking by big hospital systems and health IT companies, and I will appoint leaders to the FTC and DOJ who will conduct a rigorous antitrust investigation of the health records market, especially in the hospital space."
Hollywood, Fla.-based Memorial Healthcare System Senior Vice President and CIO Jeffrey Sturman says his system could take care of patients better if the EHR vendors, including Epic and Cerner, provided more capability for interoperability. The health system is on Epic and he sees the company taking a step in the right direction with the Epic App Orchard, an online marketplace for third-party developers to offer apps that run on Epic software, but that doesn't solve the problem of true integration.
"Interoperability is something to strive for and that we want to achieve," he said. "There will always be functional and vendor differences that will make different EHR platforms viable…but allowing seamless patient integration to take care of patients better should be something that can be accomplished."
Right now, Mr. Sturman says his system spends an inordinate amount of time trying to communicate with other health systems across the country that use various EHR vendors. Being located in Florida, his system cares for retirees who spend the winter in the warm climate but also spend half the year in New York, Chicago or other locations. Part of his responsibility is to figure out where his patient population overlaps with other health systems, such as Mount Sinai in New York or Rush in Chicago and educate providers about what they need to do to share records with those systems.
With patient care at stake, health systems are on board, but companies have been slow to develop, and it may take extra prodding to achieve true interoperability.
"We live in a capitalistic world and I get it," Mr. Sturman said. "Opening things up is contradictory to competition and is challenging for vendors to get around, but if the government mandates it, they would have to comply."