The Tip of the Iceberg


Jonathan M. Niloff, MD
Chief Medical Officer

Data recently posted by HIMSS Analytics confirms the great variability of electronic health record platforms within hospitals and their affiliated providers.  Health systems are running an average of 16 distinct EHR platforms among their affiliated practices (Tom Sullivan, HIMSS Analytics, posted May 16, 2018).  Seventy-five percent of hospitals had more than ten outpatient EHR vendors and only 2% had a single EHR vendor at all of their practices.  This poses a great challenge for interoperability within a health system, but the problem is magnified when one considers the challenge of interoperability between health systems given the large number of acute care (inpatient) electronic health record vendors.

But this is still the tip of the iceberg.  We see significant heterogeneity among clinical documents (CCDs, CDAs) among all the EHR brands, and there are over 100 certified EHR brands.  Moreover, we see differences in the clinical documents even within different instances of the same brand.  The interoperability challenge grows.

But, still not the whole story.  There are over 4 million clinicians (physicians, nurses, physician assistants, etc.) documenting clinical care in electronic health records today.  And most of these clinicians were trained in the pre-EHR era.  This introduces differences in how clinical documentation is performed, which brings even more variability to the clinical documents.

Any variation in clinical documents creates interoperability challenges.  It seems unlikely that this variation will be addressed within all the disparate EHRs any time soon.  That means that solving this interoperability challenge will need to be addressed in another way.  Given the scale of the problem, the solution cannot be multiple manual mapping exercises.  An automated solution that works at scale is needed.

Diameter Health offers such a proven solution.  The Fusion Engine normalizes clinical documents with a fully automated, plug and play solution.  It also deduplicates, enriches and organizes the data to make it ready for analytics and quality reporting…  Given the challenges of clinical documents and the disparate EHRs from whence they come, the Fusion Engine is the fastest and most cost-effective route to meaningful interoperability.

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