Will Epic’s interoperability shift produce meaningful change?

The introduction of the Trusted Exchange Framework and Common Agreement (TEFCA) brought about significant changes in the healthcare industry, putting pressure on leading Electronic Health Record (EHR) systems like Epic to adapt and prioritize interoperability. An initiative by the Office of the National Coordinator for Health Information Technology (ONC), TEFCA aimed to establish a nationwide health information exchange infrastructure. It imposed a minimum set of interoperability standards, creating a framework for the secure and seamless exchange of patient data among healthcare providers.

Epic, a dominant player in the EHR market, largely felt these interoperability pressures. With an estimated 77% of Americans’ data stored in its software, Epic faced the challenge of aligning its system with the new rules and regulations.

Epic had gained a reputation for being highly customized and often uncooperative with other systems, leading to data exchange problems with healthcare organizations using other EHR systems and preventing healthcare organizations from using applications or plug-ins that would allow them to align their EHR software with their specific needs.

This “made it harder for physicians to practice and has proven to be a consistent roadblock to true interoperability across the healthcare industry,” said Glen Tullman, a former CEO of AllScripts and current CEO of Transcarent, a startup seeking to simplify health insurance benefits, told STAT. “Everyone knows this, but few want to acknowledge it publicly.”

Ideally, healthcare organizations would be able to choose the best-performing apps and add-ons to integrate seamlessly with their EHR. This is certainly the marketplace that the 21st Century Cures Act aims to create, but historically dominant market players created contractual and technical barriers that prevent this from happening.

One technical barrier was the use of gag clauses that barred users from sharing screenshots related to software design. Created to protect intellectual property, the gag clauses stagnated data exchange by limiting the integration and compatibility of technologies that could provide personalized and potentially better tools for healthcare providers and patients.

Through the 21st Century Cures Act’s data sharing laws, gag clauses are now prohibited, and software developers are just now peeking over a wall that had long been kept up.

This year, Epic has made moves toward interoperability, but will their pivot bring meaningful change?

Epic joined TEFCA and brought its clients

In a move toward interoperability, Epic joined TEFCA in February, bringing their extensive network of big-named clients with them, including Mayo Clinic, NYU Langone Health, and Stanford Healthcare. Participation in TEFCA is currently voluntary and Epic’s pledge created a boost in the new and emerging interoperability framework program.

Connection Hub

Epic also launched Connection Hub, a database for vendors that are interoperable with Epic. Vendors can self-report if their service or application can achieve successful data exchange with Epic systems.

Additionally, through Connection Hub, Epic will provide services to vendors to include technical support, testing sandboxes, and tutorials to foster connection and interoperability.

While Epic’s participation in TEFCA and the launch of Connection Hub are positive steps towards interoperability, time will tell if these efforts will be sufficient to overcome historical barriers or if further EHR innovations and standards will be desired.

The true success of TEFCA and the achievement of a nationwide health information exchange infrastructure will depend on the industry’s ability to overcome challenges and foster collaboration among EHR systems for the benefit of healthcare providers and patients alike.

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Divurgent is a solutions provider committed to healthcare IT evolution, and the strategies and processes that make it possible. It helps hospitals, health systems, and affiliated providers with payment and delivery reform, operational efficiency, patient engagement, and raising the quality and lowering the cost of care to improve outcomes towards healthier communities.