Healthcare's continuing struggles to make data-sharing a reality across the healthcare system are outlined in a series of case studies (PDF) presented to HHS' Office of the National Coordinator for Health Information Technology.
The studies, prepared by social research group NORC at the University of Chicago, focused on six states' health information exchanges (HIEs): Iowa, Mississippi, New Hampshire, Utah, Vermont and Wyoming. The Wyoming exchange later closed because of financial issues.
“A critical need for strong, ongoing support related to standards and interoperability” exists, the researchers concluded, and “a provider- or federal-led effort to obtain buy-in from HIE developers for overarching HIE goals may be warranted and needed to change perceptions of interoperability.”
The state HIEs have been funded, to the tune of $564 million, through ONC's electronic health-record incentive program, and are envisioned as aids to data-sharing throughout the healthcare system.
The report emphasized that there must be a “critical mass of data available” for providers to find the exchanges useful. If not, providers accessing the exchanges will question the value of the system. That result particularly affected providers in Iowa, Utah and Vermont, the report argued.
“Even when more data becomes available in the future, [officials] fear the users who have been disappointed previously will not bother to return to use the system,” the report concluded.
Also, data quality has been a challenge for many. “For example, a patient's address may show up in the name field or the name field may have numerical values instead of text. In more extreme cases, once a patient is deceased, systems may not consistently record and share this information with other systems,” the report noted. The result is a potential negative impact on patient care and negative consequences for stakeholder trust in—and use of—the information exchange.
Technology may solve that problem: Utah, for example, is investing in patient-matching algorithms to help clean up data.
But the report suggested that more effort is needed from the federal government to ensure that data flows more freely. The feds need to continue to push standards and other levers to ensure data fluidity, and they also need to push EHR developers to make their products interoperable with the information exchanges.
The report admitted that “in some ways” interoperability “runs contrary to the business interests” of EHR developers, and that government policy actions might be helpful to ensure that providers have information exchange options.
Follow Darius Tahir on Twitter: @dariustahir