National Health IT Week: Moving Toward EHR Interoperability

Tom Bizzaro
Tom Bizzaro

Guest post by Tom Bizzaro, RPh, vice president of health policy, FDB.

National Health IT Week has come and gone. The industry is focused on how far IT has come and how far it needs to go in healthcare. As most organizations have now adopted electronic records, one of the big themes this week has been EHR interoperability — getting these systems to work together.

Earlier this year, the Office of the National Coordinator for Health IT (ONC) published a 10-year vision to achieve an interoperable health IT infrastructure. The ONC publication is meant to move the industry toward the much coveted interoperability that will enable healthcare organizations to seamlessly share patient information. The simple fact that the federal government has issued this call to action and the industry is embracing it is a good sign for the future of healthcare. We will finally be able to share vital patient information that helps us improve care for individuals and populations, while cutting some of the unnecessary costs out of the system.

While the report is encouraging, this is a very real industry where change only comes after considerable effort. To help move toward the interoperable nirvana quicker – or at least make the journey more palatable — we need to:

Demand more specificity

To truly move toward the realization of interoperable systems, we need more specificity than what was originally offered in the ONC document. While the overall plan is great, it serves more as a rallying cry than as an operator’s manual. For example, the plan focuses on the processes that could lead the industry to create more interoperable systems, where it would be good to also define the specific outcomes. In addition, we need more specific requirements related to how messaging schemes and codes should actually be used.

More explicitly call for a standardized vocabulary

The report calls out five “building blocks” — core technical standards and functions; certification for adoption and optimization of products and services; privacy and security protections; supportive business, clinical cultural and regulatory environments; and governance. However, the report does not explicitly call for a standardized vocabulary. While it may be implied that such standardization is warranted, more emphasis needs to be given to the importance of speaking the same language. After all, without such standardization, sharing information becomes an exercise in futility as the receivers of the information cannot take meaningful action.

Recognize the importance of a national patient identifier

Each person in this country needs a single identification number that will make it possible for providers to quickly assess the patient’s unified records. This is becoming more important as we start to share information via interoperable systems. Transferring information among various organizations does very little good if the end-user can’t identify who the patient is. The national patient ID is often criticized as something that would decrease privacy. The fact of the matter is a patient ID most likely would not have a significant detrimental effect on privacy.

Continually weigh the value of sharing vs. the value of protecting information

Certainly, protecting personal health information is important. And, healthcare providers should constantly look at stepping up their efforts to do so. At the same time, healthcare organizations and patients need to look at the value that is inherent in sharing information – and weigh that benefit against the risk of privacy breaches. By doing so, they might realize that while we should do everything we can to protect personal health information; we should not let privacy concerns deter us as we create the interoperable systems that will so radically improve outcomes.

Make sure only the good survive

Currently, there are many vendors that are offering subpar EHR systems in the market. Obviously, healthcare organizations won’t be able to realize a high level of interoperability as they deploy these less-than-optimal systems. While the market is likely to consolidate and the vendors offering quality systems will probably be the ones standing at the end of the proverbial day, we need to encourage this to happen sooner rather than later.

Keep the momentum going

Sure, moving toward interoperable systems takes considerable effort. Already, healthcare professionals have devoted tens of thousands of volunteer hours to the effort. It is a worthy cause, though – as developing an interoperable health system will lead to the improved clinical care, better patient outcomes and reduced costs throughout the healthcare industry.

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