Four years after the passage of the American Recovery and Reinvestment Act and the subsequent investment of billions of federal dollars in an e-health system, sharing patient data outside a health care system remains a significant obstacle, according to eHealth Initiative's 10th annual survey of health information exchanges (HIEs).
Today, the use of EHRs and other electronic information systems have made data sharing within hospitals and health networks routine. However, the survey shows that health care delivery organizations are increasingly challenged by the need to interface with clinical and administrative systems outside of existing networks. Three-quarters of the 199 survey participants report that they have had to construct numerous interfaces between different systems to facilitate information sharing, a process that is both time consuming and expensive.
"The recent challenges with insurance exchanges have helped people understand just how difficult it is to connect data, whether it's clinical, personal, or administrative," says Jennifer Covich Bordenick, CEO of eHI. "It's relatively simple for providers within a hospital using a single EHR to share information about their patients. The real challenge and expense is getting dozens of different systems to talk to each other," adds Bordenick. In fact, 68 organizations have had to build 10 or more interfaces with different systems, and more than 140 cited interoperability as a pressing concern.
Despite these challenges, the eHI survey shows increased confidence in HIEs as a viable, sustainable business. The new demands associated with health care reform and meaningful use requirements have led providers to turn to HIEs for support, which is encouraging from a business standpoint and may help reduce reliance on federal funding. However, the burden of sharing data between different systems may ultimately threaten the sustainability that HIEs have worked so hard to achieve. "The use of different standards, products, and approaches for managing health information means HIEs have to spend time and money to bridge the gaps," acknowledges Covich. "Any groups that rely solely on federal funding, which expires next year, will not survive."
The survey also shows that many HIEs have not yet developed ways to allow patients to enter or view their own data in the health exchanges. Only 31 organizations currently offer patients access to their information. Moreover, even simple patient engagement services, like tools for managing appointments or prescriptions, are rare. As part of the federal EHR Meaningful Use Program, patient engagement is a critical step for providers looking to receive incentive payments for using EHRs. This could change in future years, as 102 organizations reported that they have plans to offer patients access to their data.
"While it's a little disheartening to see such low patient engagement, overall I think we're in a better place than we were last year. Awareness around health care reform has helped build the business case for data sharing and engaging consumers," says Bordenick.
Source: eHealth Initiative