As congressional action looms, eminent informaticists define EHR interoperability

Fortunately, it looks as though we may have the basis of a definition of “open records,” aka interoperability, from two noted medical informaticians, Dean Sittig, professor of biomedical informatics at the University of Texas Health Science Center in Houston; and Adam Wright, a senior scientist in the general medicine division at Brigham and Women’s Hospital, a senior medical informatician at Partners HealthCare, and an assistant professor of Medicine at Harvard Medical School, Boston.

Their work, “What makes an EHR ‘open’ or interoperable?” was published Monday in the Journal of the American Medical Informatics Association.

Here are Sittig’s and Wrights’ five basic tenets of an open record:

    • An organization can securely extract patient records while maintaining granularity of structured data.
    • An authorized user can transmit all or a portion of a patient record to another clinician who uses a different EHR or to a personal health record of the patient’s choosing without losing the existing structured data.
    • An organization in a distributed/decentralized health information exchange can accept programmatic requests for copies of a patient record from an external EHR and return records in a standard format
    • An organization can move all its patient records to a new EHR.
  • An organization can embed encapsulated functionality within their EHR using an application programming interface (API). Goals: access specific data items, manipulate them, and then store a new value.

“Healthcare delivery organizations should require these capabilities in their EHRs,” the authors concluded, and “EHR developers should commit to providing them.” Further, the systems should be tested and certified as capable of meeting these interoperability criteria, they said.

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