During this past week, there were multiple news items and announcements related to the topics of interoperability and health information exchange. This caught my attention because, even though interoperability has been one of my areas of focus for a several years, I can’t recall a similar timeframe when the topic was so visible in the headlines. One not-so-surprising announcement was that clinicians want access to health information so that they can meet the needs of the patients they serve.
This week, a survey published by the Bipartisan Policy Center Health Information Technology Initiative, Clinician Perspectives on Electronic Health Information Sharing for Transitions of Care, reported that 70 percent of clinicians believe that lack of interoperability and an exchange infrastructure, and the cost associated with both, are major barriers to electronic information sharing.
The survey also found that a majority of clinicians believe electronic exchange of health information will have a positive impact on healthcare. This Clinician Survey confirmed the 2011 HIMSS Nursing Informatics Workforce Survey results which found that lack of integration/interoperability was the top barrier to success.
According to survey results, health IT can play a critical role in supporting high-quality, patient-centered, cost-effective care. The report also states that, “the newly emerging, coordinated, accountable, patient-centered models of care require IT that can facilitate the efficient and safe exchange of health information across multiple clinicians and provider organizations.” This exchange of information is especially important during transitions of care, when responsibility for a patient’s care is “handed off” from one clinician to another.
Another news item released this week shows that we are, at least, pressing on the interoperability accelerator to make forward progress.
A newly formed public-private partnership of states, public agencies, federally funded health information exchanges and health IT companies, called eHealth Exchange, announced it has established a program to test and certify electronic health records and other health IT to enable reliable transfer of data within and across organizational and state boundaries.
According to the news release, “this coalition of 15 states, 37 technology vendors and 34 HIEs, representing more than 50 percent of the U.S. population, has created a robust, highly automated testing program to verify that, once tested, a system is capable of exchanging health information with many other systems. With this testing, a single set of standardized, easy-to-implement connections can support communication among systems.” This effort intends to build on and accelerate consensus on national standards, adopting EHR certification criteria and testing procedures as relevant and finalized for Meaningful Use Stage 2.
From a practical perspective, an increasing number of vendors and healthcare organizations are focused on achieving interoperability that will support the long-term vision of care transitions and care coordination.
As an example, over 110 health IT companies and research organizations participated in the 2012 Integrating the Healthcare Enterprise (IHE) North American Connectathon, successfully testing more than 180 health IT systems for cross-vendor information exchange. This represents an increase of more than 20 percent over the 2011 event and indicates expanded recognition of the value of standards-based interoperability to enable effective and secure sharing of health data.
During the 2013 IHE Connectathon to be held in January, participants will test the interoperability of transitions of care using the HL7 Implementation Guide for CDA® Release 2: IHE Health Story Consolidation, as recently adopted in the Meaningful Use Stage 2 Standards and Certification Criteria Final Rule.
For an example of how important this is, one only needs to turn to the recent Wall Street Journal article in which we learned that the CDC and state health officials scrambled last week and over the weekend to track down patients who received contaminated steroid injections to see if they had become sick, and to warn them to watch for possible symptoms of meningitis. It seems clear that if CDC health officials lack access to critical public health data, electronic exchange of health information is NOT having a positive impact on health- care today.
In composite, the interoperability efforts I’ve noted above can enable health information to follow the consumer, be available for clinical decision-making, and support appropriate use of health information beyond direct patient care, to improve population health.
But, are we truly making progress, or are we simply stalled in neutral, while forming new groups and coalitions, and funding new organizations and efforts that will take more time and resources to get us further down the road? Only time will tell, but in the meantime, interoperability is top of mind, and that is definitely where it needs to be.
Are you involved with any of these evolving interoperability activities?
If so, what are your thoughts on their potential impact?
Do you think we are making progress, and if not, what will it take to get us to the electronic exchange of health information that has a positive impact on health care?
I welcome your thoughts and look forward to our ongoing dialogue.