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What Is Being Done About Healthcare's Lack of Interoperability?


Patients, providers and payers are not reaping the benefits of electronic health records.

Macbook, Apple, stethoscope, doctor, interoperability

Only 51 percent of non-federal acute care hospitals had necessary patient health information electronically available from healthcare providers and outside sources at the point of care, according to the Office of the National Coordinator for Health Information Technology’s (ONC) 2018 Report to Congress about the implementation of a nationwide system for electronic data sharing.

And while the lack of interoperability of electronic health records (EHRs) is no new story, patients, healthcare providers and payers are still not reaping the benefits of the technology.

Many patients do not have access to their own health information, despite the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule that grants patients the right to access their health data. With a lack of access, it is more difficult for patients to manage their health and shop for medical prices.

>> READ: HHS Issues Draft Strategy to Reduce Health IT Burden

As previously mentioned, healthcare providers lack access to patient data at the point of care. This happens when multiple providers have different pieces of data, own different systems or use health information technology (IT) solutions purchased from different developers.

Payers lack access to clinical data on groups of covered individuals, which prevents them from properly assessing the value of services provided to their customers.

“Without the capability to access multiple records across a population of patients, healthcare providers and payers will not benefit from the value of using modern computing solutions — such as machine learning and artificial intelligence — to inform care decisions and identify trends,” the report authors wrote.

While none of this seems promising, health IT developers are working with hospitals and provider practices to identify needs that would provide upgrades that support interoperability and improve user experience.

Congress provided the U.S. Department of Health and Human Services (HHS) the authority to enhance innovation and promote use and access of electronic health information in the 21st Century Cures Act.

The law has provisions that can promote the development and use of upgraded health IT capabilities, establish transparent expectations for data sharing through open application programming interfaces and improve the end user experience.

HHS and ONC want to maximize the promise of health IT in efforts to accelerate value-based transformation in healthcare. HHS wants health IT to help the flow of health information for patients, healthcare providers and payers and to promote competition in healthcare markets.

According to the report, as of 2015, 96 percent of non-federal hospitals and 78 percent of office-based physicians adopted certified health IT.

Based on interoperable health information exchange capabilities in 2015 and 2017, 90 percent of non-federal acute care hospitals and 48 percent of office-based physicians are electronically exchanging patient health information with any healthcare providers outside their organization. But only 53 percent of non-federal acute care hospitals can integrate electronically received health information into their health IT.

There are many barriers associated with interoperability and data sharing, which limit the access and use of electronic health information — technical, financial and trust.

Technical barriers limit interoperability through a lack of standards development, data quality and patient and data healthcare provider data matching. Financial barriers relate to the costs of developing and implementing health IT, like the lack of sufficient incentives for sharing information between healthcare providers. Trust barriers are legal or business incentives that keep data from moving.

But efforts are being made to advance interoperability and bring modern computing to the healthcare and health IT industry.

Public and private sectors have built on existing actions to implement the Federal Health IT Strategic Plan 2015-2020 and the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap to continue working towards widespread use of all forms of health IT and to continue to find new information and ways to disseminate knowledge quickly, securely and efficiently.

The Centers for Medicare and Medicaid Services (CMS) and ONC are working with stakeholders and payers to decrease documentation requirements for patient encounters, address reporting burden to simplify program requirements and identify the best practices of health IT to improve efficiency, experience, workflow and satisfaction of end users.

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