Aired on December 9, 2010
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Information technology (IT) is really the enabler of health information exchange (HIE). With health IT experience within the Department of Defense (DoD) and the Department of Veterans Affairs (DVA), I have witnessed how IT has become more robust and scalable enabling the exchange of information between physicians, organizations and between local state, and federal government agencies. Read more
HIE needs to be user friendly, seamless, and performed “in the background” where it does not impact the clinician or care provider. You don’t want the care provider to be engaged directly with the information-sharing process – the data needs to be in the right place at the right time, for the right patient. From an enhanced clinical care perspective, HIE also has the ability to improve the quality of care. If HIE is done properly, clinicians won’t need to recollect patient information, it will just flow seamlessly through the echelons of care.
Expert Reactions: Rita Torkzadeh, Senior Consultant
The introduction of federal-level incentives for Health IT adoption alongside new quality-driven financial models are spurring significant activity among providers and within the health industry in the United States to achieve ARRA HITECH Act’s Meaningful Use criteria. Health reform objectives related to accountability and patient-centered care coordination depend on advancing health information exchange and cooperation among all healthcare stakeholders who provide, receive, and pay for care. This also shapes how vendors develop their products where interoperable capabilities are being prioritized to meet newly created and evolving federal certification and information exchange requirements. Healthcare market dynamics, particularly with Health IT vendors, are changing to expand information exchange capabilities beyond the vendors’ own products or population the healthcare entity serves. This has not been as much of an issue in countries that have different healthcare systems, and where the numbers of Health IT vendors are small and well-articulated. In the United States, consumer engagement, demand, and market forces, guided by this administration’s national health IT agenda , will help advance adoption and technology’s value as health IT becomes more pervasive in physicians’ practices in the United States.
“HIE has reached a tipping point and part of it is driven by major changes being introduced by the healthcare reform agenda. The current administration is a strong supporter of HIE and believes that a seamless, robust, standards-based, and scalable HIE backbone will be critical to the provision high quality, cost effective health care in the future. Timely, accurate, and complete patient information, provided in a ubiquitous and unobtrusive manner, will help clinicians better understand their patient’s medical history and make more informed decisions on patient health care needs. Examples of benefits to be derived from HIE include: improved patient safety, improved outcomes, better manage cost, and reduce medical errors.”
~ Jim Reardon, Senior Associate
Expert Reactions: Rita Torkzadeh, Senior Consultant
I agree with Dr. Jacobs and don’t subscribe to the “build it and they will come” philosophy when it comes to Health Information Exchange (HIE), or any other Health IT implementation effort. The key to effective use really depends on how well the system is designed and optimized for the end-user, whether that is Dr. Jacobs who values viewing his patients’ active medications, or any other provider or consumer of health information that interacts with technology across the care continuum. It takes time to get this right in standalone environments in the absence of interfaces. When you start throwing in information exchange capabilities there is added complexity involved in building and maintaining that interoperability, not all of which is technical. Dr. Jacobs’ ability to continue seeing a patient’s current medication history may rely on health information exchange to obtain updated pharmacy-specific information, but also depends on whether and how the medications that are not ordered and recorded using standards-based computerized methods are documented in the Electronic Health Record. HIE can add value where information from different sources, including patient-driven Personal Health Records (PHRs), serves to close information gaps in practice-based systems and improve clinical decision support among physicians that have a more complete picture of the patient.
Expert Reactions: Jim Reardon, Senior Associate
I agree that a stable and certain policy environment/forum will be a critical enabler to the future of Health Information Exchange. Deven has mentioned the need for robust and flexible privacy and security policies which can be applied at all levels—local, state and federal—and address the deep seated concern with the protection of health information. The challenge in developing, vetting, testing, and implementing policies is convening the right blend of subject matter experts, from a variety of venues, such as business, academic, and non-profit, that are willing to work through the complex issues associate with health information exchange and make the compromises necessary to move the process forward toward completion. As Deven states, when we address the development of local, state and federal policies, it will be critical that we have the courage to make the difficult policy decisions.
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Senior Associate with expertise in health IT, public health informatics, children’s health and immunization, and IT program management.
Senior Associate and former member of the DoD Senior Executive Service (SES), bringing deep expertise managing large, complex health information technology programs.
Senior Consultant with expertise in clinical and patient information systems, health informatics, and interoperability of health information.
