The Office of the National Coordinator for Health IT has begun listening sessions to identify and understand the experience and barriers of organizations as they prepare to scale up health information exchange.
Participants in the first listening session were concerned about confidence in the patient data policies among connecting networks, assuring patient identification, variations in technical exchange standards and the need for a framework for trust.
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“ONC has embraced health information exchange, the verb. There are lots of different methods for this to occur. As long as we can get closer to this vision of information liquidity to benefit the patient, it’s good,” he said at the Jan. 17 online governance town hall.
ONC decided not to issue federal regulations around rules of the road for nationwide health information exchange, but rather to support existing governance activities that organizations have started to advance widespread exchange.
The question is how to “assure that the flow between such providers does not pose artificial barriers,” he said.
As providers access a network to request information about a patient, exchange organizations may have variations in their policies for rules of the road for query-based exchange, according to Paul Wilder, vice president of product management for the New York eHealth Collaborative, a state-designated entity. New York has about a dozen regional health information exchanges (RHIOs), each with its own policies based upon the state’s governance standard.
“We see what happens when we have these policy gaps, between what is defined but still broad enough, that it’s difficult if you’re not 100 percent harmonious. You end up with data liquidity going down to almost negative because once one side thinks that their policies and their interpretations within that boundary is appropriate, and the other side does not have the same thing, the two entities cannot connect,” he said.
For example, one RHIO, which stipulates that only physicians may look at patient data, won’t exchange with a RHIO that also allows nurses and front office staff as part of a covered entity to view the information. “That mismatch means both sides don’t trust each other," Wilder added, "and the data stops.”