HHS told to standardize consent, privacy in e-health record exchanges

Health care IT executives weigh in on department's Federal Health IT Strategic Plan

The Health and Human Services Department’s new strategic plan for health IT doesn't go far enough in standardizing the ways in which patient consent for release of personal health information would be managed, a group of health care CIOs said April 18.

HHS in March published its Federal Health IT Strategic Plan for 2011 through 2015, which outlines activities for fostering widespread adoption of health IT and information sharing. The plan covers the period in which HHS is continuing distribution of $20 billion of economic stimulus funding to doctors and hospitals that buy and meaningfully use digital health record systems. The “meaningful use” requirements include exchange of patient health data to be aggregated for clinical, research, public health and budgetary purposes.

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However, the College of Healthcare Information Management Executives, which includes many hospital and health plan CIOs, said they have submitted a letter to HHS advising that the strategic plan does not go far enough in defining how patient consent management and privacy would be handled while exchanging health data.

“Several of the objectives listed throughout the plan foresee the fluid exchange of the right information, at the right time, for the health and safety of patients,” they wrote. HHS "needs to further define how consent management should be handled, and it must address the responsibility of patients, physicians, hospitals and insurers on how consent will be stored and transmitted through health information exchanges.”

The consent management system also must deal with information coming in from patients’ personal health record systems, which are generally patients’ own online repositories of their own health information in digital formats.

The health IT executives also want greater uniformity in health care data privacy laws from state to state.

The group wants HHS to establish standards for a national privacy regulatory environment that would apply to all health information exchange. Under current policies, there are geographic variations in privacy rules, which complicates compliance and makes it more costly, they wrote.

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Reader comments

Mon, Apr 25, 2011

Anthelio Healthcare Solutions is pleased to participate in providing comments on the Federal Health IT Strategic Plan for 2011-2015. Please find them below:

We are pleased to see a national focus on patient care. It’s been a significant time for health care, but we still have a long way to go. And while meaningful use is necessary, it’s not enought to harness the power of health IT to transform health care over the next 5 years.

Much like the meaningful use requirements, we’re concerned that this plan paints a laudable vision without an agenda for accomplishment, from a financial standpoint

Measurement remains to be a major shortcoming throughout the plan. Simply put, there is a lot of what, but not much how.

Electronic health information is the “lifeblood” of Modern Healthcare, but we need to figure out a way to keep that lifeblood flowing. The government must further convince us that the current investments hospitals are making are on track.

Reduction of health care costs through the use of health IT can and should be accomplished, but it can’t be done through health IT alone. For too long our processes have been broken. The implication that health IT will reduce health care costs is misleading.

There is a disconnect between individuals and their interests, while focusing on outcomes and improving population health. The two don’t necessarily go hand in hand. The idea of improving population health through the use of evidence based medicine and the emergence of equitable care is a healthy one, but let’s be careful not to overstate individual interests.

We’re concerned by the lack of innovation in the rapid implementation of “one size fits all” solutions. Lots of money is being spent by hospitals in trying to achieve meaningful use, but not enough thought is going into the bigger picture, potentially causing dollars to be spent now for processes that may need to be undone in the future.

Electronic medication reconciliation to reduce unnecessary hospitalizations is spot-on, but a clear plan is necessary to measure the effect.

There is a lot of credence paid to the creation of the Regional Extension Centers in the plan. Again, we need to measure their success.

The mention of private insurers mirroring Medicare with rewards for meaningful use is noteworthy. We would like to see steps toward legislation to make that happen.

The efforts toward making EHRs more usable are noteworthy and necessary. Many EHRs on the market are not meeting our needs, but are being pushed anyway, despite the possible cost prohibitive repercussions. More discussion about the role of personal health records is vital, as is more discussion about the potential use of open source. Clearer steps need to be put in place to measure the return on our investment.

For complete comments from Anthelio, please visit the following: http://www.healthyinnovation.net/?p=114

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