But we’ll only get there if we work together, says Julie Klapstein, CEO of Availity, a health information exchange organization based in Jacksonville, Fla., in a podcast of her talk at the Third Annual World Congress Leader Summit, titled “The Road to Interoperability.” She succinctly summed up the issue of successful EMR interoperability: It requires that many disparate bodies work together — and that’s hard.

“Collaboration isn’t for sissies,” noted Klapstein. “It takes real innovation. [Participants] have to agree to collaborate on a common portal and a common solution. … It’s really about leadership over self-interest in proprietary solutions.”

Have Your Data and Share It Too Think you can’t blaze an interoperable trail because you’re just a physician? Think again. Consider these two doctor-driven examples that rippled out to some serious success: Amazing Charts EMR — Jon Bertman couldn’t find that magic combination in an EMR — free and feature-filled. So he wrote the program for his own. That goal ended up being harder to achieve than the Hope Valley, R.I.-based solo doc thought it would be, as Bertman didn’t even know how to write a computer program at the outset. It also cost him about $10,000 in development costs. Nevertheless, Amazing Charts is now a player in the EMR market. And, its creator is also heavily involved in promoting EMR interoperability. Using a standard data transfer protocol called CCR, or Continuity of Care Record, Amazing Charts users can easily pull their patient data and upload it to another CCR-accepting EMR. “You can go into the admin section and export all your data as a CCR or Excel file,” he says. Bertman is deeply committed to EMR interoperability, saying, “It’s one thing to say you’re interoperable; it’s another to let you truly take the data out.” He admits that the CCR does have its limitations; right now it can be used to transfer data between primary care-based EMRs. Bertman says, “CCR is slowly moving toward interoperability with specialists — OB/GYN to internist, ophthalmologist to family practice. … We’re dedicated to do it; because that will become the gold standard.” A3HIE — About five years ago, four Michigan practices in the greater Ann Arbor metropolitan area all independently settled on the same EMR (NextGen). They got to talking. Wouldn’t it be great to be able to share patient information? Today, they do. With assistance from NextGen and the resulting establishment of the Ann Arbor Area Health Information Exchange (A3HIE), a regional health information exchange (RHIO), Huron Gastroenterology Associates, Integrated Health Associates, Michigan Heart, and Michigan Multi-specialty Physicians can tap into a central repository to access up-to-date medical information on 780,000 area patients. It took some time to figure all this out (the groups didn’t go fully online until 2007). Still, this endeavor has changed the way these 250 physicians and 50 nurse practitioners care for patients. “We do a prescreen process now before seeing a new patient,” says Bobbi Summers, an applications specialist at Huron Gastroenterology. “We can ding the portal, and bring [the new information] into the chart. Medication management can be time consuming; now the meds are just there. … Before we didn’t know anything about the patient. Now we know.” Some things were surprising, she says. “We didn’t realize how many other groups a patient might have gone to. We have such a wide range of specialties within these four groups.” Executive director and executive vice president of A3HIE, Carlotta Gabard, who used to be Huron Gastro’s IT expert, agrees. “I’m startled by how many patients I see who have gone to all four practices,” says the former vice president of Integrated Health Associates, in charge of information systems and billing. But that’s not all. Thanks to this pilot project, NextGen benefited as well. Today, there are about 16 similar enterprises across the country, says Scott Decker, vice president for NextGen. “It’s really taking off. We’re rolling out two to four per quarter.”

Shirley Grace, MA, is associate editor for Physicians Practice. She can be reached at sgrace@physicianspractice.com.

This article originally appeared in the October 2008 issue of Physicians Practice.