Is Lack of EHR / EMR Interoperability Stifling the Rollout of mHealth?

I have been thinking about this topic for a while.  To some, the question doesn’t even have to be pondered, the answer is “YES”!   But to others, there are factors surrounding mHealth applications and their adoption and rollout that can’t solely be  blamed on the lack of interoperability between health records. I wanted to wait until I attended HIMSS this year (Chicago) and American Telemedicine Association (ATA) (Los Angeles) talking with many people about this very subject. Actually, the question was much broader.  “Do you feel that mHealth is being held back and if so, what are the reasons?” (Yes, I know that’s a leading question.) The general consensus regarding mHealth and the lack of adoption are the following:

  1. So many apps to choose from (last year it was 100,000 apps and counting in healthcare / wellness).  Many that are single purpose, used for a short period of time and may never be used again.

  2. The apps are not sticky.   They are not like email where we check it 150x per day, text or retrieve our voicemails.   Although people believe that apps that track calories or steps have a chance, most agree that they get used for a short period of time then get chucked in the drawer.

  3. The apps lack a business model and form of payment.  Many believe that this is just starting to get addressed, but has a ways to go.

  4. Lack of integration into the clinicians’ work flow is a major barrier.  Clinicians don’t want to go to another system to reference the data.   The lack of interoperability into the many EHR / EMR solutions is definitely something that individuals have noted is holding back at least mHealth app / solution vendors for getting their solutions integrated into a doctors office easily.

Do physicians trust patient-generated data?

There is one element that keeps ringing out there and that is that physicians may not “trust” the data that is patient-generated or self-entered.   I believe that many physicians, however, believe that the patient-generated or self-entered data is just another reference point among all of the other data that is coming into them and that they weight it appropriately.   The underlying in many circumstances is not the data, but the act of compliance on the patients part to a prescribed routine by the physician.  Once the physician can change a patient to be more compliant, they have the teachable opportunity to influence other changes.

I have come across several mHealth app / solution companies that have created great applications that are needed on the market to better prepare a patient for procedures and enable better compliance, but because of the effort to integrate into a physicians backend EHR / EMR, the cost benefit does not always provide a model that makes it beneficial to integrate the solution.   In many of these cases, practice by practice may have a different EHR / EMR and worse yet, they may be premise base at the practices location that means customized local changes will need to be done instead of creating the integration once for the EHR / EMR, which increases time and costs

What do you think?

I want to hear your thoughts on this. Do you believe there is an issue with lack of interoperability? I have just pointed out one example, but there are more likely many that are causing issues.

Are there efforts under way to solve this problem in the short term, or will the government need to step in to force sharing of patient data?   Is Meaningful Use 3 a carrot or stick that will help with this lack of interoperability?

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