Panel seeks Rx for secure health data exchange

Health care providers and vendors face many obstacles in implementing a common set of standards for electronically exchanging patient health data nationwide, according to testimony before a federal advisory workgroup today.

The Health IT Standards Committee’s Implementation Workgroup heard from several large and small health plans, hospitals, doctors' practices and vendors. The workgroup, chaired by federal Chief Technology Officer Aneesh Chopra, is gathering information on how to set standards for secure health data exchange systems.

The committee will forward its recommendations to the Health and Human Services Department, which will consider them for upcoming regulations later this year for distributing $20 billion in Medicare and Medicaid incentive payments. The payments will go to providers who buy and "meaningfully use" certified electronic health record systems.

Some of the health plans have set up pathways to exchange data through HHS’ Nationwide Health Information Network (NHIN) pilot project.

“Our greatest success may be the full implementation of care coordination via the NHIN, starting with federal partners like the Veterans Affairs Department and using the standards already recommended for meaningful use,” Andrew Wiesenthal, associate executive director of the Permanente Federation, said on behalf of the Kaiser Permanente Medical Care Program.

However, Wiesenthal also acknowledged “frustrations” in implementing standards for data exchange, including competition for resources with projects that have a more rapid or direct clinical effect. Consistent federal, state and local support could help solve those problems, he said.

Dick Taylor, chief medical information officer for Providence Health and Services, said Providence has learned several lessons from working on data exchange for a decade.

“We have been challenged by our own workflows, by the time-limited and relatively nontechnical environment in our providers’ offices, and by the maintenance ‘tail’ inherent in custom self-designed solutions," Taylor said. "We have learned and suffered from the limitations of read-only access to systems and clinical summaries that can be viewed but not effectively integrated."

The situation improved in 2009 as the industry reached a critical plateau of standards-based data exchange, he added.

“Changing technology is easy; changing workflows is hard,” said Rich Warren, chief information officer of Allegiance Health community hospital. “Adoption is all about workflow, behavior modification and perceived value.”