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Articles

Aug 20 : Interoperability, EHR data quality of top concern to industry

ehr data

Author Name Jennifer Bresnick

Senators Ron Wyden (D-OR) and Chuck Grassley (R-IA) may not have been expecting such an avalanche of input from the health IT industry when they requested comments on the struggle to turn disparate EHR systems into an interoperable network of high quality health data, but the responses just keep pouring in.  More than a dozen provider groups and leadership organizations have written to the lawmakers to express their support of the urgent need for interoperability, health information exchange, centralized registries to encourage clinical analytics, and industry-wide standards to underpin the data-driven healthcare ecosystem.

Here are highlights from some of the responses to the Senate Finance Committee provided by industry experts.

Why healthcare data must be accessible and interoperable

 

Healthcare reform efforts that include the shift to accountable care and the introduction of population health management techniques rely on clean and complete data sources that support the delivery of coordinated, cost-effective care, says the Bipartisan Policy Center. “Streamlined, meaningful quality metrics are critical to organized systems of care, and can facilitate public reporting of information that consumers can use to make decisions about their care and that providers can use to understand how their performance relates to their peers.”

The American Hospital Association adds, “Healthcare-related data is a growing but largely untapped resource for accelerating improvement in health care quality and value.  The ability to make that data available and useful in a meaningful way will impact health care delivery and consumers for years to come.”

“Patients and families need easy access to information that helps them evaluate the options open to them for their specific medical conditions, the relative risk and benefit of available options, and the quality and cost of such options (often hyper-variable and regionally-specific),” says the Gary and Mary West Health Institute. “Given that most personal bankruptcies in the country are related to healthcare debts, it is essential that whenever possible, the total cost of care to be borne by the patient be available prior to commitment to a specific treatment plan.”

Addressing data quality and fragmentation

 

Despite the growing need for robust data sources, healthcare information remains fragmented in disparate systems that cannot interact in a seamless way.  The American Medical Group Association (AMGA) calls this state of affairs “completely inadequate,” and urges more investment in clinical analytics that can harmonize data sources and generate meaningful insights for providers and patients.

The Pacific Business Group on Health (PBGH) encourages the development of multi- and all-payer claims databases that can inform employers’ decisions about provider networks and empower consumers with information about the cost of treatments and services among various hospitals and doctors. While these databases are statewide initiatives, federal support for harmonization of data collection standards among states would encourage their proliferation by minimizing the reporting burden for multi-state payers.”

Patient privacy must still be paramount

 

While making data accessible to more stakeholders is important, the patient must remain at the center of all decision making.  Ensuring patient privacy is vital if healthcare organizations want to maintain trust and make healthcare information truly useful to the consumer.

The National Committee for Quality Assurance (NCQA) notes that “privacy rules are not intended to impede good patient care. Current privacy rules under HIPAA explicitly authorize sharing of data for most medical treatment, payment and operations purposes, but are often misinterpreted as precluding this very type of essential data sharing.”

“Secure HIE that protects patients’ privacy rights and honors their wishes and directives is at the core of implementing broad data sharing among providers, payers, patients, and other stakeholders,” adds the HIMSS Electronic Health Record Association (EHRA). “It is widely recognized that the inconsistencies in various state and federal privacy laws as they pertain to sensitive health information, such as that protected under 42 CFR Part 2 (Confidentiality of Alcohol and Drug Abuse Patient Records), continue to be obstacles to widespread HIE. . . Harmonization of state privacy laws is essential, therefore, in order to deliver a mechanism that provides a nationwide, privacy-focused legal framework for access and disclosure of sensitive PHI based on patient-directed consent.”

“While many consumers are concerned about misuse of personal health information, most do want their data shared as long as they know with whom and why, and to meet care needs,” NCQA concludes. “They also understand that problems result when information is not shared as needed for care coordination purposes. Further study on the logistics, limitations, and implications for recording and adhering to patient-stated preferences for data sharing is warranted.”
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