Interoperability is the ability of different systems to exchange and use health information. For rounding physicians in post-acute settings, it is a practical daily issue - not a technical concept.
When a patient is admitted to a skilled nursing facility, their history from the hospital should follow them. When a rounding physician documents an encounter, that note should be accessible to the nursing staff and the care coordinator in the facility. When a patient is discharged, the rounding physician's summary should flow to the next provider.
Most of this works imperfectly in practice. Here is why, and what to look for.
The Interoperability Challenge in Post-Acute Settings
Post-acute care involves more fragmented systems than almost any other clinical environment. A typical SNF may use one system for nursing documentation, a different system for the facility's clinical records, and connect to referring hospitals through a health information exchange. Rounding physicians are a third layer, with their own EHR that needs to connect to all of the above.
The technical standards for data exchange - HL7 and FHIR - exist to make these connections work. But implementation varies widely. A data feed that works between an acute hospital and a large health system may not have a connector for the rounding physician's platform.
Where Interoperability Actually Matters for Rounding Physicians
Admission data. When a patient arrives at a facility, the rounding physician needs their prior history. How does that history get into the rounding EHR? If it requires manual entry from a faxed face sheet, that is a manual process with error risk. An EHR that integrates with the facility's ADT (admission, discharge, transfer) feed automatically populates new patient demographics.
Lab and diagnostic results. Rounding physicians often order labs from external providers. Results need to reach the rounding EHR for clinical decision-making and documentation. If results come through a fax or a separate portal login, they may not be consistently incorporated.
Care team visibility. When a rounding physician completes a note, nursing staff and care coordinators should be able to see the relevant plan of care elements. In facilities using PointClickCare, for example, a rounding EHR with a PointClickCare integration can push notes and orders directly into the facility's record.
Discharge summaries. When a patient leaves a facility, the rounding physician's documentation should follow them. This affects transitions of care quality, readmission risk, and the next provider's ability to continue care effectively.
What Good Interoperability Looks Like for a Rounding EHR
Direct integration with common facility systems (PointClickCare, MatrixCare) for patient data exchange
ADT feed support for automated patient list updates
Lab result integration or import capability
Ability to send notes and care summaries to facility records and referring providers
ONC certification for compliance with federal interoperability requirements
ChartPath EasyRounds integrates with PointClickCare and supports HL7 and FHIR data exchange. Rounding physicians who use both systems get automated patient list updates and the ability to share documentation with facility care teams without a separate step.
If interoperability with your facility network is a requirement for your next EHR, ask vendors specifically which facility systems they integrate with and what that integration includes.
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