We recently commissioned a HIMSS Analytics white paper that consists of several CIOs and VPs from hospitals and healthcare systems of all sizes. We were looking to get unbiased information about where the industry currently stands with interoperability activities, what challenges are causing the most difficulty, and what steps are being taken to overcome the obstacles. HIMSS Analytics did a fantastic job and I encourage you to download the full report:

Current State of Health Data InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information and to use the information that has been exchanged. in the U.S. Trends, Challenges and Strategies for Success.

There are three distinct themes stand out in the report:

  1. Aligning stakeholders involved in health information exchange is challenging, especially public/state exchange organizations
  2. Various connectivity strategies are being employed
  3. Industry consolidation will have significant impact on future IT decisions

Yet, despite these challenges, every participant said that interoperability is, without a doubt, their organization’s top priority.

Let’s briefly explore challenge number one listed above, the difficulty of aligning multiple stakeholders in the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health... More process. There are two different HIE scenarios on display in the HIMSS Analytics report:

  • A hospital in the Midwest has put in the hard work to meet the meaningful use requirements to exchange CCDContinuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR)... More documents with their statewide HIE. The public HIE, unfortunately, cannot accept CCDs, forcing the hospital to submit data that cannot be indexed for other facilities to access.

Summary: The state HIE, likely started thanks to government grant money, cannot accept patient data from caregivers in the government-mandated format. (From Merriam-Webster: Irony – a situation that is strange or funny because things happen in a way that seems to be the opposite of what you expected.)

  • The second scenario describes a hospital in the Northwest that cannot utilize their state’s HIE due to lack of a master patient index, or MPI. Despite their membership in the HIE, they are not confident in using data from the HIE because they are unsure the information they receive will match the intended patient.  

Summary: Different patient identifiers from multiple applications and facilities create doubt, which in turn makes reliability in HIE data low. What is the benefit of costly HIE participation if the same amount of human investigation is required to identify patients as needed prior to HITECHAs a part of the America Recovery and Reinvestment Act (ARRA) of 2009, Health Information Technology for Economic and Clinical Health (HITECH) refers to the portion of the ARRA that is used to increase the use of Electronic Health Records (EHR) by ph... More and EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform... More adoption?

While the information in the report does illustrate the high level of skepticism about public HIEs, it should not be used as an indictment for all HIEs. There are many HIEs that have proven to be financially viable and have created high value for member organizations. Over the next few years the marketplace will likely weed out the HIEs that have not solved the important interoperability details.

In the meantime, we will continue to work to give provider organizations flexibility to adapt to all standards that exist in the HIE marketplace. Corepoint Integration Engine allows our customers to send data to HIEs in any format required and will also parse and standardize data received HIE data so that it can be incorporated into the EHR. 

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