A local hospital might have a large enterprise EHR system. The system designed to be a ‘general’ system for all areas of Medicine. This requires many fields and the providers to mold to the system. This system can be difficult to use since the system is not designed around a specific Medical Specialty. Pediatricians have much different day to day patients than Cardiologists. The EHR sales representatives might call the practice and provide concerns that if they do not use their system, the practice might have a challenging time working with the hospital system. The physicians and other providers might have entered a few hospital orders in the EHR system in the hospital but not seen 20-30 patients in a day in their office (big difference). For some of these reasons, there are practice owners that believe they need to use the same system adopted by their local Hospital.
The government was concerned about interoperability in the health care system and provided a solution that allows a physician practice to choose the appropriate EHR for their practice and not be forced to choose the Hospital EHR system. Through the HITECH act, the Health and Human Services are funding the ability for states to have Health Exchanges. Hospitals in the state as well as laboratories will connect to these Health Exchanges. This means that any EHR system can connect to the exchange to share data (lab data, hospital data, etc.). Once the exchange is built, the practice only needs to connect to the exchange and will be able to send and receive appropriate data for any hospital in the state. This provides the practice the flexibility to choose any EHR system (assuming the EHR company has the experience/technology to link to the exchange) while not giving up function. Practices should choose an EHR system based on the quality of the product and the service.