In the last full year of the Obama administration, federal policymakers remain so focused on interoperability that sessions on the topic will dominate an annual gathering hosted by the nation's top information technology office.
More than a quarter of the nearly 40 sessions at next week's seventh annual Office of the National Coordinator for Health IT conference will deal with interoperability.
One session will set a baseline on the industry's progress, while another will cover better measures for achieving health information exchange.
Last fall, the ONC released an updated version of its “Interoperability Roadmap,” which called for providers to be able to send and receive electronic clinical information nationwide by the end of 2017.
In a session Wednesday, the American Hospital Association is scheduled to release its latest data as well, and outline remaining barriers to interoperability goals at the two-day gathering in Washington, D.C.
Earlier this year, the American Hospital Association reported (PDF) that in 2014, 57% of hospitals could exchange records with facilities outside of their systems, and 60% could trade information with outside ambulatory care providers. Those numbers were up from 22% and 37%, respectively, in 2013.
After all, through April, the feds have paid out $34.5 billion to 4,924 hospitals and 493,612 physicians and other eligible professionals in electronic health record incentive payments.
That means nearly all hospitals and 92% of physicians and others eligible to receive incentive payments have been paid to buy, install and eventually "meaningfully use” an EHR system that's been tested and certified as capable of sending and receiving patient information. And yet, gaps remain.
Chantal Worzala, AHA's director of policy said despite the federal funding meant to incentivize providers to update their systems, outdated technology still exists.
“The actual exchange may be challenging,” Worzala said, adding that data exchange is complicated by the inability to accurately match patients. And there's another policy challenge: the federal privacy rules surrounding required patient consent, said Devi Mehta, health privacy policy analyst with the Office of the Chief Privacy Officer at the ONC.
While the Health Insurance Portability and Accountability Act does not require patients' consent for most uses of their electronic medical information—for treatment, payment and many other healthcare activities—patients can demand that providers withhold sending their medical records to their insurer if the patient pays for a visit or procedure out of pocket.
Other privacy use cases where a technology fix for patient consent might prove useful include moving patient records from federally funded drug and alcohol-abuse treatment providers; moving veterans' records about certain medical conditions outside the Veterans Health Administration; and disclosing mental health records under certain state privacy laws more stringent than HIPAA.
In addition, those working on President Barack Obama's Precision Medicine Initiative are recommending electronic consent management, while many states have their own requirements regarding health information exchange.
Aside from interoperability, several ONC conference sessions will cover health IT and public health, including one on the challenges in the expected battle with the Zika virus. That panel will feature ONC representatives, as well as Dr. Sanjeev Tandon, the EHR project lead at the Center for Surveillance, Epidemiology and Laboratory Services at the Centers for Disease Control and Prevention.
Another conference session plans to focus on creating ways—other than surveys—for measuring progress in achieving interoperability. One suggestion is to devise a system for the adoption, use and conformance of interoperability standards. Panelists also will explore ways to gauge the level of health information exchange with behavioral health and social services providers.
A third interoperability session will focus on so-called “computable privacy,” useful when providers need to create, store and implement patient-consent directives as a precursor to health information exchange.
