Near-term solutions for data exchange and security challenges
More than $29 billion has been spent so far to promote the use of electronic health records, but the industry’s progress toward interoperability remains slow. Even though many doctors and hospitals have adopted EHRs to capture patient information electronically, only a small percentage are able to routinely exchange that data with other providers.
Evidence suggests that some vendors and providers have gone so far as to deliberately block the exchange of health information, fearing they will lose business by sharing patient data with competitors. Congress is taking steps to prevent such information blocking by imposing fines on those charging exorbitant fees to transfer information or those refusing to share information with providers outside of a given health network.
Still, providers using systems from different vendors are not typically able to share data electronically. EHRs rarely communicate with each other, and even less frequently with the long list of ancillary systems managing health-related data outside the EHR. A 2015 article in The New York Times described these obstacles to digital record sharing, using an example from a family physician who prints his notes and sends copies to a hospital across the street when admitting a patient. Even though his clinic has an electronic records system, it’s different than the hospital’s and will therefore not exchange data electronically.1
Because of these interoperability challenges, most hospitals receive either paper or faxed copies of physician orders and notes, and physicians in turn request copies of patient test results and treatment plans. In the event that records are missing or delayed, patients are forced to wait for providers to track down needed information. And in the absence of a necessary result or scan, providers must reorder tests, which increases costs and delays patient care.
Interoperability Road Map
Leading the interoperability charge, the Office of the National Coordinator for Health Information Technology (ONC) released its final road map in October and set forth a goal of exchanging a “core data set” of patient information nationally by the end of 2017. This is a step toward improving the flow of health information across the care continuum to improve quality and coordination. According to the ONC, “The Roadmap coordinates public and private sector efforts to advance the safe and secure exchange of electronic health information across the country to improve individual, community and population health.”
With the roadblocks encountered in the journey so far, the health community is left with many questions about the practical, actionable steps needed to get there. Hundreds of federally-funded health information exchange projects have been launched with limited success because of the inherent challenges of managing complex, evolving clinical data. Clear definition, stability and structure of tens of thousands of clinical data elements will be required for meaningful exchange to occur between systems.
Challenges of Traditional Methods
In the meantime, providers and payers continue to communicate largely through traditional paper-based methods—risking data loss, errors and security breaches along the way. Data collection occurs at every point of the patient encounter, beginning before the patient arrives at the hospital and continuing as providers work to coordinate care with physicians and insurance companies.
Resources are consumed by manual efforts to fax, print, route and scan paper records. Critical information is exchanged by phone and left on voicemails. But when information is needed to coordinate patient care, hospitals and payers are often at a loss. Many exchanges are either undocumented or inaccessible, stored in paper and computer files that cannot be quickly searched or exchanged.
Without a method to link these disparate exchanges to the patient account, providers are unable to form a complete and searchable view of information surrounding the patient. The resulting gaps compromise care quality and efficiency and put hospital outcomes and performance at risk.
Facilitating the secure electronic exchange and management of patient health data is critical for providers to effectively manage the volume and complexity of information now surrounding patient care. Safeguards are needed to ensure that data is accessible, but only to those authorized to view it. Providers cannot wait for a security breach or dangerous error to occur before implementing HIPAA-compliant methods to manage and exchange information between systems and covered entities.
Solutions That Streamline
The industry is in need of an immediate solution for data exchange and security challenges, one that can be implemented now as the work of structured clinical data exchange and EHR interoperability continues in the years to come. Solutions that streamline the process of getting the right information to the right people will result in faster response times, smoother transitions and better continuity of care in the interim.
With health information exchange solutions that facilitate the secure, auditable exchange of data in its current state—whether paper, electronic document, fax or voice—providers have a way to manage unstructured content and share it between systems. By capturing and digitizing patient data using the provider’s current means of exchange, these solutions give providers the ability to form a comprehensive view of patient health data exchanged across the continuum of care.
Combining these disparate data sources into a single, secure and integrated repository allows providers to close gaps in documentation for a unified view of patient information. Each record is tied to the patient account for easy search, retrieval and sharing. Data from the EHR and ancillary systems is combined with unstructured data—from sources such as verbal exchanges, faxes and paper documents—to encompass the full spectrum of available information.
An integrated platform provides a way to safely store and transfer data, protecting sensitive records while making information accessible to authorized viewers. A central point of access supports processes with tools to automatically and securely share records between systems and team members, tracking access points along the way. This allows providers to eliminate paper—along with time consuming, error-prone processes—for greater efficiency, security and consistency across the care continuum.
As the work of interoperability among EHRs and other systems continues, the industry must adopt interim solutions to facilitate the secure and efficient exchange of patient information among providers, ensuring that relevant information is available at the point of need. A digital audit trail of information exchanged across departments, systems and entities provides valuable business intelligence to improve care coordination and promote better health outcomes for patients.
- Pear, Robert. “Tech Rivalries Impede Digital Medical Record Sharing.” The New York Times. May 26, 2015.