Sharing medical information between EHRs: 4 different approaches

In the same way that a master patient record is only part of the solution, a standardized user interface by itself does not solve the problem of data sharing.  However, it would dramatically simplify aggregating data either into a patient-centric master record like Apple's approach or into a Google-like solution such as Care Studio.  

The current COVID pandemic has brought into stark contrast the woeful state of medical data collection and data sharing in the United States. It has been a central goal of Health and Human Services (HHS) to at first encourage and later mandate sharing clinical data across multiple electronic health records. Unfortunately, progress has been slow and actual clinically useful widespread adoption of shared medical data remains an aspiration.  Here, we discuss the pros and cons of 4 different approaches to sharing clinical data across various EHRs.

The solution mandated by HHS envisions a common set of software tools that will allow different EHRs to query and import data from any “certified” EHR. This is the so-called Fast Healthcare Interoperability Resources (FHIR) initiative and despite large expenditures of both time and money spent implementing this approach; it has not gained widespread use.  The original intent of FHIR was to share data in real-time from multiple incompatible electronic health records (EHRs), and incorporate data into each. FHIR is based on a series of complex pre-formed templates which currently limits the amount and type of data that can be extracted, but the basic and insurmountable impediment to this approach is that FHIR assumes that all records are complete, consistent, current, and accurate.