Interoperability of Health Information

Helping state and federal organizations work toward Electronic Health Records (EHR).

Part of the current health care reform debate involves the need to computerize patient medical records. Electronic health records (EHRs) would help the medical community share information more easily and assist the public health system in detecting and addressing threats to populations, such as the spread of the current H1N1 flu virus.

“It is overwhelming when you think about what public health is and what it encompasses, such as food safety, environmental safety, immunizations, epidemics, and disease tracking and registries,” says Rockville-based Senior Associate Margo Edmunds, PhD. “In a lot of places, public health is also the safety net provider, the provider of last resort.”

Dr. Edmunds, an expert in health policy, moderated a session on Strategies for Interoperable Health IT Architectures at a recent Public Health Information Network (PHIN) conference. Session participants—members of the enterprise architecture community of practice—discussed how to build an interoperable national public health network in which medical data can be efficiently collected, shared and used.

While doable, the actual task of creating interoperable EHRs is quite complex, involving both human and technological challenges. The first challenge is helping patients and doctors understand interoperability and the need to share information for public health research and planning purposes. “Most medical records exist on paper and are difficult to share,” says Dr. Edmunds. “In addition, physicians have enough to do just taking care of patients, especially in smaller offices. It’s very hard for them to do public health reporting.” As a result, she says, many diseases are underreported.

The next barrier to automating health records is the job of developing a common technology architecture and software applications that have the capacity to communicate, exchange data accurately, effectively, and consistently, and use the information that's been exchanged. “Interoperability is important for both the clinical and public health communities,” says Dr. Edmunds.

On the clinical side, interoperability means that doctors, labs, hospitals, and anyone else involved in patient care can all access the same record and read it in the same format. In the public health arena, interoperability would help states aggregate and analyze data, in order to do population health planning. “Paper records are not interoperable,” says Dr. Edmunds. “Yes, paper can be scanned, but imagine the reams of paper that would have to be reviewed. It can’t be done easily and quickly.”

Booz Allen is addressing the challenge of interoperability—from working with clients at the national policy level to helping develop IT tools, such as natural language programming that enables information from different people to be aggregated automatically. “We work across the spectrum of public agencies involved in healthcare,” she says.

The firm’s thought leadership is also helping the healthcare community understand the issues and challenges of interoperability. “We recently conducted a study examining the ways that health IT, in combination with communications technology, can accelerate progress toward the goal of a patient-centered healthcare system,” says Dr. Edmunds.

The widespread adoption and sharing of EHRs gets paper out of the system, but it’s just one step toward a system of free-flowing information and communications, according to the study.  The study’s findings were published in a Booz Allen white paper entitled "Toward Health Information Liquidity:  Realization of Better, more Efficient Care from the Free Flow of Health Information."

story posted November 9, 2009