While a persistent problem for many years, only in recent times has interoperability been scrutinized for the purpose of removing barriers for health/patient information exchange. Congressional pressure has led  major Electronic Health Record (EHR) vendors, with much reluctance, to begin looking at developing framework for enabling interoperability. Of course the issue remains complex and dynamic with various factors affecting the implementation of interoperability.


First, the legacy EHR vendors are accustomed to working in defined environment with particular way of functioning – offering little in terms of adaptability or ‘innovation’. The hospital, affiliated partners and other technology solution providers must adapt to the EHR – the hefty investment made by the hospital compels them to center their IT strategy around the EHR.


Second, the EHR vendor’s function in silos – protectionist behavior inhibits progressive health IT strategy and implementation. Each vendor insulates themselves within their feudal kingdom wishing only to expand their reach over more healthcare systems without particular concern about the future needs of the healthcare systems as a whole. What ensues is not only the lack of interoperability between EHR’s, but also difficulty in integration with other technologies such as mHealth remote patient monitoring.

Third, from the perspective of companies offering digital health solutions for patient management and remote care, high barrier to entry such as integration difficulty diminish the attractiveness of opportunities. Thus, the solution provider loses the opportunity, the hospital loses on effective patient management and care, and ultimately the patient loses for not benefitting from advanced care. For EHR vendors, the status quo remains.

Now of course, the above scenario is a bit extreme but barriers to entry remain high for small businesses offering eHealth solutions. The problem is exacerbated by the fact that there might be limited interest on part of the EHR vendor to welcome smaller companies rather than swallowing them.   

Until greater governmental and more importantly market pressure isn’t placed on the legacy EHR companies, a real push for interoperability will not occur. That, however, may be a blessing in disguise. The lack of interoperability has opened market entry for eHealth companies specializing in HIE & interoperability. In the next article, we will discuss more about HIE & Interoperability opportunities.

Web of patient health data centralized into EHR.

Web of patient health data centralized into EHR.