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March 1, 2016

Interoperability progress: How these 16 health systems plan to unlock health care data

Daily Briefing

See the Advisory Board's take on this story.

The Obama administration on Monday announced commitments from various health care stakeholders to help advance the interoperability of electronic health records (EHRs).

HHS Secretary Sylvia Mathews Burwell during the Healthcare Information and Management Systems Society convention said participants in the initiative pledged to:

  • Implement national interoperability standards;
  • Improve electronic data sharing among providers, including by halting the practice of "information blocking"; and
  • Make it easier for patients to access and use information in their EHRs, including by assisting consumers with accessing their electronic health information.

Burwell said, "It's great to have an [EHR], but if that record can't be easily accessed by doctors and patients because of clunky technology, then we aren't consistently seeing the benefit."

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She added, "We are working to unlock health care data and information so that providers are better informed and patients and families can access their health care information, making them empowered, active participants in their own care."

Health systems, other stakeholders sign the pledge

Several major health IT companies, health care systems, and other stakeholder organizations have committed to the effort.

Participating groups include 17 health IT developers that provide EHR systems to 90 percent of hospitals in the United States, including Allscripts, Athenahealth, Cerner, Epic, and Meditech.

Sixteen health care systems also have committed to the initiative:

  • Ascension Health;
  • Carolinas Healthcare;
  • Catholic Health Initiatives;
  • Community Health Systems;
  • Dignity Health;
  • Geisinger Health System;
  • HCA;
  • Intermountain Healthcare;
  • John Hopkins Medicine;
  • Kaiser Permanente;
  • Lifepoint Health;
  • Mountain States Health Alliance;
  • Partners Healthcare;
  • Tenet Healthcare;
  • Trinity Health; and
  • University of Utah.

Professional organizations participating in the initiative include the American Academy of Family Physicians, American Hospital Association, and American Medical Association.

While the plan lacks a specific timetable, HHS in the fall plans to follow up with participating organizations to ensure they are working toward their pledges (O'Donnell, USA Today, 2/29; Conn, Modern Healthcare, 2/29; Sullivan, The Hill, 2/29; Alonso-Zaldivar, AP/Sacramento Bee, 2/29).

The Advisory Board's take

Kenneth Kleinberg, Health Care IT Advisor

This announcement is a step in the right direction, and it will aid the industry in improving interoperability.

However, it's important to put this pledge into context: It represents a public commitment by stakeholders to make decisions that the market was already pushing them to make. Some organizations may have signed on because they see the risk and effort as minimal.

That's still a net positive—getting people to "shake hands" and agree to these commitments makes it easier to track their progress and see if they are following through. But there are still several outstanding questions about when some of the confines of the pledge will actually happen.

For instance, some organizations have said they are willing to adopt new interoperability standards when they are "mature," but even when the standards are ready it may take years for vendors to adopt them, delaying implementation for providers. Other commitments that may seem promising, such as expanding patient access to medical records, reflect trends already underway.

The biggest challenge with data exchange remains ensuring compliance with quality data in defined content structures. Specifications for data exchange such as Continuity of Care Document (CCDs) already exist, but many providers do a poor job of completing CCDs, and vendors have been more focused on creating CCDs than assimilating them into the workflow and the EHR.

To overcome these problems and achieve meaningful interoperability, we'll need trust and mutual benefit among shareholders, agreement on standard formats and event triggers, selection of certified vendors, consent management, governance, and goals to improve care, cost, and access. Today's commitments represent progress, but we've got a lot more work to do.

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