Have you ever struggled to get your medical records transferred between doctors’ offices or healthcare systems? Or tried to piece together your full health history when no one provider has the full picture?
For patients and providers alike, fragmented, inaccessible data has long posed a major frustration and barrier to quality care. But the era of digitized medicine offers new hope for connectivity and continuity of care—if healthcare organizations can get on the same page.
That's where standardized electronic health records (EHRs) come in. By adhering to common guidelines and criteria, EHR systems can “talk” to each other, enabling the seamless, secure exchange of patient information. Critical details like medications, diagnoses, labs, imaging, and procedures can follow individuals wherever they go, supporting better-informed, coordinated care.
Yet effective standards don’t happen by accident. Behind the scenes, numerous entities work rigorously to define, implement, regulate and update EHR standards across the sprawling, complex healthcare ecosystem.
This coordinated effort is the key to unlocking the full potential of digitized health data to improve care quality, cost-efficiency and patient outcomes.
In 2004, the Office of the National Coordinator for Health Information Technology (ONC) was established under the Department of Health and Human Services (HHS) to oversee and coordinate nationwide adoption of EHRs. Recognizing the pivotal role that standards play, ONC has spearheaded initiatives to:
A major milestone came with the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which called for the “meaningful use” of EHRs. To that end, ONC worked closely with the Centers for Medicare and Medicaid Services (CMS) to launch the Medicare and Medicaid EHR Incentive Programs in 2011. These programs defined progressive standards in three stages for how EHRs must be used to improve care, with financial rewards given to compliant providers.
This represented a tipping point, spurring investments in certified EHR systems. As Eligible Professionals and Eligible Hospitals attested to meeting Meaningful Use objectives, EHR adoption surged. By 2017, 86% of office-based physicians and 96% of hospitals had implemented certified health IT systems.
Central to the meaningful use vision was ensuring that EHRs could share information securely—a prerequisite for coordinated care and improved health outcomes. Hence interoperability and health information exchange figured prominently in the required standards.
Other criteria focused on patient engagement, safety, care coordination, population health management and clinical quality reporting.
|Stage 1 Objectives||Stage 2 Objectives||Stage 3 Objectives|
|Electronically capturing health information in a standardized format||More rigorous health information exchange and interoperability||Improving quality, safety and efficiency with decision support, patient access and medical information reconciliation|
|Implementing drug-drug and drug-allergy interaction checks||Empowering patients with online access to health information||Reporting on advanced clinical quality measures, public health data and resource use|
|Maintaining active medication and allergy lists||Strengthening clinical processes like e-prescribing and test result tracking||Focusing on improved outcomes via patient-centered coordinated care|
|Using EHRs for care planning, ordering, viewing lab results, messaging||Reporting clinical quality measures and public health data||Leveraging application programming interfaces (APIs) for data access and exchange|
Through this staged approach, Meaningful Use drove measurable improvements on multiple fronts while familiarizing providers with certified systems, accelerating standards adoption.
Although the Medicare and Medicaid EHR Incentive Programs ended in 2021 after disbursing over $38 billion in rewards, the solid standards foundation they fostered continues shaping healthcare’s digital trajectory.
But what specifically constitutes “EHR standards”? That’s where organizations like Health Level Seven International (HL7) come into play. HL7 focuses on developing comprehensive standards, guidelines and methodologies for the structured, coded exchange, integration, sharing and retrieval of electronic health data. These serve as the nuts and bolts enabling EHR systems integration and interoperability.
HL7 standards span clinical and administrative data including:
Among the most widely adopted HL7 standards are:
These complement other important standards including:
Mastering this “alphabet soup” of protocols enables the structured capture, storage and transmission of health data between diverse systems. It allows medical histories to flow across providers, regardless of where or by whom care was delivered.
Defining standards is one thing. But how is adherence verified? Again, a multilayered approach across public and private entities aims to uphold rigor.
The ONC oversees EHR product certification through its Office of the National Coordinator for Health Information Technology Certification Program (ONC Health IT Certification Program). Software developers voluntarily submit products for certification testing by ONC Authorized Testing Labs. Those meeting criteria are ONC Certified and listed on the Certified Health IT Product List.
Certification aims to verify EHR systems’ ability to:
To maintain certification, developers must adhere to ongoing standards evolution and requirements as stipulated by ONC. This encourages product enhancement supporting advanced interoperability.
Yet responsibility does not end with vendors. Healthcare organizations must properly implement certified systems along with associated policies, workflows and training that enable meaningful use.
The Office for Civil Rights (OCR) enforces HIPAA regulations governing security and privacy of patient health data. Providers found noncompliant may face fines or corrective action plans.
Meaningful use audits by CMS evaluated providers’ standards application, assessing factors like:
Those failing to meet requirements faced Medicare/Medicaid reimbursement penalties.
Compliance resembles a three-legged stool, supported by:
This end-to-end accountability aims to uphold the integrity and maximum benefits of standardized EHR systems.
The path to optimized, interoperable EHR systems requires diligence from all healthcare stakeholders. As standards continue evolving, organizations must stay up-to-date to realize the promise of seamless, ethical data exchange.
For medical practices and clinics, choosing the right EHR platform is essential. Calysta EMR provides a comprehensive solution designed for smooth practice management and robust data connectivity.
From operations to patient data and suppliers to client communication, Calysta consolidates everything in one HIPAA-compliant platform. As a cloud-based system, it ensures real-time synchronization across users so you always have access to the latest information when making clinical decisions.