Interoperability across the healthcare system is badly needed and also obtainable for providers and other stakeholders, according to a new report from the Bipartisan Policy Center, a Washington, DC-based think tank, and the Healthcare Leadership Council, a coalition of senior healthcare leaders. Less clear is how all of the players can actually attain the goal of smooth, seamless, secure health information sharing across disparate systems. The report puts forth some concrete ideas.
The two groups stated that an interoperable health system must be one in which "the patient is at the center of care and the right data are available to the right person at the right time," one in which "access to high-quality, accurate, and actionable data is seamless and integrated within clinical workflows, providing value and convenience, as well as reducing healthcare costs. There is trust in the system; privacy is protected, and information is kept secure."
Progress has already been made, according to the report. The 21st Century Cures Act and recently proposed rules from the Department of Health and Human Services represent important steps in the right direction. Ninety percent of hospitals and 48 percent of office-based physicians now electronically send and receive patient health information with providers outside their organizations; more patients have gained access to their own health information online; and the percentage of U.S. non-federal acute care hospitals that electronically share information from outside their systems has nearly doubled, from 23 percent in 2014 to 41 percent in 2017.
Despite these strides, more remains to be done. The report recommends leadership and action in the following four areas:
Strengthening the business case for interoperability, a three-pronged step that includes 1) aligning incentives among payers and providers to encourage agreement on baseline expectations for interoperability and information sharing; 2) aligning incentives among providers and their health information technology vendors, with an emphasis on collaboration to drive baseline expectations for products; and 3) engaging individuals to identify their own expectations regarding access to information.
Improving technical infrastructure by 1) adopting common standards to improve patient matching and exploring patient-centered approaches to identification; 2) requiring real-world testing by the Office of the National Coordinator for Health Information Technology (ONC) to assess adherence to interoperability standards in the ONC Health IT Certification Program; and 3) pursuing the rapid adoption of Fast Healthcare Interoperability Resources (FHIR)-based application programming interfaces (APIs) to accelerate information sharing.
Improving policies and regulations with specific goals of 1) implementing a common notice of information access for patients, in which healthcare organizations would agree on a standard and voluntarily make such notice available to patients and make it easier for them to access their health information; 2) aligning state privacy laws with the Health Insurance Portability and Accountability Act (HIPAA); and 3) aligning consent policies for substance abuse disorder treatment with HIPAA.
Enhance governance and leadership through collaboration between public and private sector leaders to identify and annually report national progress on interoperability and information sharing that is designed to bring information to the point of care and give individuals access to their own health information. These efforts should include private sector actions that will help to accelerate progress on key metrics.
The complete report, Advancing Interoperability, Information Sharing and Data Access: Improving Health and Healthcare for Americans, is available here.