Healthcare IT Interoperability Gets a Boost

Susan Nunziata, Director of Editorial | 11/2/2012 | 9 comments

Susan Nunziata
Modern healthcare must include secure interoperability between disparate IT systems. A public-private partnership to enable health data sharing looks to be a major step forward.

The goal is to test and certify electronic health record (EHR) and health information exchange (HIE) platforms so that data can be transferred easily -- whether within a single healthcare enterprise or across organizational and state boundaries.

This is no small matter. In a single hospital campus today, disparate systems may be unable to exchange crucial data about a single patient, such as medication history, lab work, and vital statistics. Multiply this by the sheer number of patients being treated by our nation's public and private healthcare systems, and the magnitude of the problem quickly becomes mind-boggling.

A Website created by the coalition partners explains the challenges like this:

A custom interface has to be negotiated and developed from each electronic health record to each health information exchange as well as between exchanges. The development of the interface and negotiation of point-to-point agreements represents a significant expenditure of cost and time for all stakeholders (physicians, HIEs, and vendors), limiting adoption and utilization of HIE.

An automated testing system -- created by a coalition of 15 states, 37 technology vendors, and 34 health information exchanges -- is designed to verify that, once tested, a system is capable of exchanging health information with many other systems. Two main groups are leading the efforts: The EHR/HIE Interoperability Workgroup and Healtheway. The former is a consortium of states and vendors that's led by the New York eHealth Collaborative. The latter is a public-private partnership of the eHealth Exchange, a network of 34 public and private organizations representing hundreds of hospitals, thousands of providers and millions of patients in the US.

According to a prepared statement released by the groups, the coalition represents more than 50 percent of the U.S. population. Participants in the interoperability initiative include the states of California, Florida, Illinois, and New York; the Centers for Medicare and Medicaid Services; Children's Hospital of Dallas; the Department of Defense and Department of Veterans Affairs; Kaiser Permanente; and the University of California San Diego.

Testing will be done by the Certification Commission for Health Information Technology (CCHIT). The testing program is designed to align with, and complement, the EHR certification effort established by the US Office of the National Coordinator (ONC), which also uses CCHIT as its testing body. According to the coalition, the Compliance Testing Program:

  • Includes a technology certification component, building upon the EHR certification program established by ONC to support meaningful use
  • Utilizes an accredited and authorized testing laboratory and certification body, leveraging the strategy implemented for the EHR certification program
  • Verifies conformance with national standards
  • Leverages national standards and work from the ONC Standards & Interoperability (S&I) Framework Initiatives

The testing program aims to more than double participation and connectivity in the next nine to 12 months. According to a prepared statement:

The coalition's work covers the ability to send and receive encrypted health information over the Internet, look up and retrieve patient records, and produce a tightly constrained patient record summary which reduces variances and implementation-specific customization.

It seems to me that if these efforts to improve interoperability and communication among the disparate healthcare organizations across the US proceed on schedule, we can expect dramatic transformations in patient care by this time next year. Here's hoping.

View Comments: Newest First | Oldest First | Threaded View
Henrisha   Healthcare IT Interoperability Gets a Boost   11/5/2012 9:11:52 AM
Re: Will the patients see the difference?
As Susan explained, I think this has more to do with making patient records more easily accessible for the professionals. It can also make statewide consults easier to do since sending over records would be instantaneous and much easier. Not sure if this could lower costs at the outset but it might in a few years' time.
rdv   Healthcare IT Interoperability Gets a Boost   11/3/2012 2:25:03 AM
Re: Interoperability!!!
Susan, more than the ego another important thing is a particular Doc/hospital has put in money to build the infrastructure and bring new technology,  unless they use it they would not be able to recover the cost of it (may lead to rise in consultation fees).  If this is going to be future of the healthcare then the CFO's should hold their hands tight before spending on new tech.

  In regards to the standardization, I like the way you put it in your last sentence...

batye   Healthcare IT Interoperability Gets a Boost   11/2/2012 11:34:13 PM
Re: Will the patients see the difference?
I think the cost could go up - someway but the access will be faster...
Susan Nunziata   Healthcare IT Interoperability Gets a Boost   11/2/2012 4:18:08 PM
Re: Interoperability!!!
@rdv: Great points and maybe beyond the scope of CCHIT which is focused on tech certifications. What you're discusing falls into the realm of human nature and medical diagnostic protocols. These factors are all interrelated of course. The best data is useless if ego prevents one practitioner from accepting information provided by another. Likewise, standardizing diagnosis protocols could potentially be a bigger diplomatic mission than achieving Mideast Peace.
Susan Nunziata   Healthcare IT Interoperability Gets a Boost   11/2/2012 4:15:17 PM
Re: Healthcare IT Interoperability Gets a Boost
@tekedge: Wow, that's a subject for another day for sure. the health insurance part of our complex healthcare infrastructure isn't part of this initiative so far, but it clearly should be. Would love to know how health data infrastructure works in nations that have nationalized healthcare. Anybody have views on that?
Susan Nunziata   Healthcare IT Interoperability Gets a Boost   11/2/2012 4:13:06 PM
Re: Will the patients see the difference?
@kstaron: great questions. Quick accessibility to patient records across providers or even across state lines would give practitioners information they need at their fingertips, without being challenged by incompatible databases. For example, there was an article in NYTimes about patients being released from the ER before their lab results were viewed by doctors because of incompatible systems and processes. Patients in some cases died b/c they were misdiagnosed. The accuracy and speed with which patient information can be relayed when and where it's needed will improve patient care.
kstaron   Healthcare IT Interoperability Gets a Boost   11/2/2012 3:07:24 PM
Will the patients see the difference?
How does this really transform patient care? Isn't just a more accessible way of getting records? hopefully this would mean that costs would go down because there's less time waste going on. What results can the patient expect to see if this works?
tekedge   Healthcare IT Interoperability Gets a Boost   11/2/2012 11:47:07 AM
Healthcare IT Interoperability Gets a Boost
@Susan - Hope the providers  find a common way to electronically input data to the claim systems of the involved insurance companies. This would lower the costs by avoiding the use of third part mail room vendors to do the scanning of all provider data.
rdv   Healthcare IT Interoperability Gets a Boost   11/2/2012 11:30:18 AM
This initiative is a good one wherein we have a centrailised database for interoperability to work... but a few question that concerns in healthcare are:

1> whether the Doctors are ready for using the information generated by some other doctor/lab/hospital.  

2> Every hospital has to have a standardized protocol for the diagnosis of ailments...

Hope the CCHIT plays a major role in here in standardizing

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