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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Health Data Interoperability Needs Information Blocking to End

Health Data Interoperability Needs Information Blocking to End | EHR and Health IT Consulting | Scoop.it

From federal government agencies and the medical industry to patient advocate groups and vendor-neutral companies, the push for greater health data interoperability with the healthcare market remains strong.


As seen in the proposed rule for Stage 3 Meaningful Use Requirements, the Centers for Medicare & Medicaid Services (CMS) along with the Office of the National Coordinator for Health IT (ONC) continue to stress the importance of health data interoperability.

ONC explains on its website that EHR systems will only reach their full promise when they effectively exchange medical data throughout the healthcare continuum. Health data interoperability through health IT systems and certified EHR technology will improve physician workflows and enable betterhealth information exchange.


There are certain health IT interoperability standards that are necessary for improving data exchange and these cover how users interact with a system, the messaging capabilities of differing platforms between each other, the management of health data exchange, and the integration of consumer tools with relevant medical systems.

While the federal government knows the importance of health data interoperability and continues to stress its importance, there may be certain entities including healthcare providers and EHR vendors that have played a role in blocking information flow throughout the healthcare industry.


Entities within the medical sector have charged large interface fees when data access requests were made and Congress is now attempting to put an end to information blocking through these means.

“Providers are fed up with interface fees and at how hard it is to accomplish the workflow required by Accountable Care business models including care management and population health. They are unsatisfied with the kind of summaries we’re exchanging today which are often lengthy, missing clinical narrative and hard to incorporate/reconcile with existing records,” stated John D. Halamka, MD, MS, Chief Information Officer of Beth Israel Deaconess Medical Center, in his latest blog post.


Halamka lays out a few key solutions for the problems surrounding health data interoperability and the ongoing issues of information blocking. First, it is important to define the necessities of care coordination and care management. Additionally, Halamka insisted that it’s time to put an end to the meaningful use requirements under the EHR Incentive Programs, explaining that they are no longer necessary.


A few other steps necessary for improving health data interoperability, according to Halamka, are: (1) creating a national provider directory in order to route messages, (2) developing a voluntary national identifier in healthcare, and (3) guiding state privacy laws to break down information blocking.


The American Medical Informatics Association (AMIA) also recently provided recommendations for improving health data interoperability within health IT systems. The organization emphasized the need for EHR certification standards that offer more technical requirements for boosting EHR interoperability and secure medical information exchange.


Additionally, more healthcare providers would benefit from developing a comprehensive healthcare IT roadmap. The latest results from Frost & Sullivan show that approximately half of medical providers worldwide do not have an IT roadmap stressing EHR interoperability. By following the steps set forth among these medical groups, researchers, and experts, the healthcare industry may be able to significantly improve health data interoperability over the next several years.

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Effects of Interoperability on Health Data Privacy Policies | EHRintelligence.com

Effects of Interoperability on Health Data Privacy Policies | EHRintelligence.com | EHR and Health IT Consulting | Scoop.it

Interoperability enables healthcare providers to make the most well-informed decisions for individual patients, but it introduces the potential for sensitive patient health data to become compromised if the technologies exchanging information or the pipeline between these systems are unsecured.

“In terms of what I think some of those challenges are, it’s no big secret; we’re working on interoperability,” Lucia Savage, the new Chief Privacy Officer for the Office of the National Coordinator for Health Information Technology, recently told HealthITSecurity.com.

“Of course there are the topics that have been well-discussed in the press, like data lock and all that stuff that have to with people’s proprietary systems,” she continued. “But what’s really more essential in the privacy and security realm is making sure people understand how are current legal and regulatory environment actually help support interoperability — right now, at this very moment in time.”

New models for care delivery (e.g., accountable care organizations) emphasize the need for interoperable EHR and health IT systems, added Savage. Interoperability, however, is limited to certain geographies and contexts. In short, there is tremendous room for improvement.

“For example, insurance companies contract with large systems to the ACOs. For that to succeed, just like the Medicare ACOs, data has to flow between the two parties,” Savage explained. “That data is flowing right now in some ways, and in some ways it could flow better and could make better use of the delivery system was built with the meaningful use incentive.”

According to the ONC’s Chief Privacy Officer, a lack of health information exchange (HIE) as a result of limited interoperability comes as a surprise to patients who “thought their doctors were doing this already.” And what is essential is that the healthcare organizations and providers, both private and public, make use of new forms of exchanging information while adhering to the privacy and security rules laid out by HIPAA.

“The HIPAA environment we have is perfectly designed for that. It’s media-neutral, meaning 20 years ago when faxes were new, that’s how the information started to move. Now the information is moving through other media but the rule hasn’t changed. We’re going to capitalize on that,” she maintained.

The next step involves the building of trust among providers and patients, which will come with time and use:

When we introduce a pretty significant technological innovation it takes optimally to breed trust. If through interoperability it facilitates physicians engaging their patients through electronic health record systems and the portal, and giving patients access, giving dialogue with patients about their data that they collect and share about themselves, then patients confidence in the system will grow because they’re using it too.

For the ONC, the path forward requires the federal agency to gather information and listen carefully to the insights of subject-matter experts so that the “potential benefits and the possible risks” of a fully interoperable, HIE-enabled healthcare environment are understood and incorporated into emerging and evolving regulation and oversight.

“Most of the people in the know understand well how HIPAA works for these big data analytics, but there’s new sources of data, whether its wearables or patient generated data or the way people want to take a healthcare transactional data and add data from public records systems to it for analytics purposes,” Savage said.

Not only is interoperability a challenge from the technology side of healthcare, but it also presents new challenges to health IT security and privacy.



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