Interoperability. For years, this was a hot topic in healthcare IT, a major challenge that provider and vendor organizations were determined to tackle (though nobody could agree on how to define it). So the industry implemented private, regional, and national networks. FHIR promised to be the future standard, while APIs promised to create more scalable solutions than old point-to-point interfaces. Standards committees and work groups continued to iterate and improve what was being shared.
We’ve trusted that this process was working and that, eventually, interoperability would get better. But we’re just not seeing that.
Patient records are a great example. Many interoperability efforts were focused on improving how patient records were shared between organizations; these aimed to give a complete view of the patient to all clinicians providing care. And looking at the volume of data moving around, it’s clear that it is more fluid than ever. However, even if the right data gets to the right place, it is often hard to find or unusable.
Over the last eight years, despite advancements, the KLAS Arch Collaborative has shown that clinicians still report external integration as the most frustrating part of the EHR experience. Those scores have been largely flat for the last eight years.
In other words, none of our efforts so far have meaningfully impacted clinicians’ experience with getting data into a usable format. The issue isn’t that healthcare lacks the technology to move data. Instead, it’s about people and processes being misaligned on how to best get the right data to the right place. So at KLAS, we’re asking an overly simplistic question: Can EHR vendors figure out how to share data with each other?
That’s what we aim to find out.
A Different Approach: Planning for Action
We’re finding that both vendors and providers so far agree that bringing EHR vendors together would be valuable. But one of the realities of healthcare IT is that vendors can’t get together on their own to figure out data sharing. Competitive distrust is an obvious barrier, but even if well-intentioned vendors get together, there can be legal concerns of collusion.
That’s where KLAS can play a role as a neutral convener. We’re not looking to host a broad forum or theoretical discussion. Rather, this effort will bring together a focused group of EHR vendors to agree on how to reduce the variability in how data is shared within established standards. We’re starting with a clear goal to align on improving how patient notes are shared.
This isn’t about inventing new standards. It’s about aligning on how existing standards are interpreted and implemented across the industry. If this works, it won’t happen in a single meeting where vendors can agree on a solution. It will require vendors to follow through and implement the solution, and customers will need to adopt it.
Culturally, organizations are used to structuring their data a bit differently from each other, but some of those differences create unnecessary barriers to data sharing. It may well be that improving data sharing requires customers to adjust custom terminology or mapping. Our role is not to dictate solutions but to bring the right people together, measure progress, and report honestly on what changes and what doesn’t.
Why We’re Starting with Shared Patient Notes
When it comes to patient record sharing, there is a lot that can be optimized to help clinicians. Some data is more structured and usable, such as problems, allergies, medications, and immunizations data, while other data is much more difficult to ingest, such as labs and notes.
Our goal is to tackle a problem that will drive a demonstrable improvement for clinicians, not just another small, incremental change. For many patient records, much of the story is found in the notes. They provide clinical context, explain decision-making, and support continuity of care. When notes don’t come across cleanly, clinicians can and do lose trust in the data.
Notes also represent a problem that is specific enough to be solvable. Success here could create a blueprint for addressing other interoperability challenges in the future.
What Success Would Actually Look Like
Success is clinicians no longer saying, “The notes don’t come across.” It’s consistent structure and metadata that allow systems to understand what kind of note is being shared and how it should be used. It’s fewer manual workarounds and less cognitive burden in already complex workflows.
And just as important, success demonstrates that meaningful progress in interoperability is still possible. It shows that focused collaboration, paired with accountability, can move the needle without waiting years for new frameworks or regulations.
And if the solution works, we don’t stop there. The long-term vision is a repeatable model: identify a specific problem, bring the right stakeholders together, align on a solution, and measure the outcome.
Don’t Give Up on Interoperability Yet
Interoperability fatigue is real, and it’s understandable. We’ve spent too much time and energy as an industry on this to have clinicians report no substantial progress. The clinician experience can improve; the Arch Collaborative has shown that ambient speech tools make a huge impact in a very short time. We just have to get creative and look for more effective ways to address the persistent challenges in sharing patient records.
This effort is an experiment. It may not be perfect. But it’s grounded in clinician experience and vendor cooperation and focused on a change that matters. Provider organizations need to continue to raise their voices on this issue. Let your vendor know that this Shared Patient Records Usability Summit matters to you and your clinicians. It’s time to move on from the status quo. Meanwhile, if you’re interested in the broader trends shaping the way we share patient records and why this focus matters now, we encourage you to read the full report behind this work.
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