Study finds clinicians still facing data exchange barriers

Additional standards that meet with broad industry agreement and consistent implementation are critical to spur the exchange of health information and value-based care, according to a new report conducted by the Bipartisan Policy Center (BPC).

The study's findings include clinician perspectives on barriers preventing them from exchanging health information with other providers, with some 71 percent of clinicians citing the lack of interoperability and HIE infrastructure as the biggest challenge.

The report also highlights the “fragmented nature” of healthcare delivery today, with BPC officials pointing to Medicare patients – who currently see seven different physicians, on average, across four different group practices. This fragmentation can significantly decrease the quality of a patient’s care, the report suggests, as it can lead to duplications, misdiagnoses and overtreatment.

[See also: More docs joining HIEs, attesting to Stage 1.]

According to a 2012 study cited by the BPC, the absence of efficient, uniform care coordination in the U.S. has cost the nation between $148 and $226 billion annually.

The wider adoption of electronic health information exchange between providers and all members of the care team proves crucial in shifting away from this fragmented, costly system, to an accountable, value-based and care coordinated system, say authors of the report.

Additional BPC findings:

  • A majority of clinicians (69 percent) cited the associated costs of developing and maintaining interfaces and exchanges as a barrier to exchanging information with other providers.
  • 25 percent of clinicians cited privacy and liability concerns as barriers to exchanging health information.
  • More than 80 percent of surveyed clinicians indicated that access to medication lists and related laboratory/ imaging tests were the most crucial pieces of health information to receive for care transitions.
  • When a patient has an urgent problem or requires follow-up care, more than 80 percent of clinicians say patient information should be exchanged either immediately or within 24 hours.
  • When receiving health information from an outside clinician or practice, 57 percent of clinicians say they prefer to “pick and choose” from that outside information to include in the EHR, compared to some 16 percent of surveyed clinicians who prefer to just upload and include all of the information.

[See also: HL7 to make standards available free for public good.]

The report also includes 12 recommendations to help spur electronic record exchange and interoperability. Among these are the necessity for different types of patient consent, the need for clear privacy standards, and the establishment of exceptions to the Anti-Kickback safe harbor and Stark laws regarding "payments associated with the electronic transmission of data that accompanies a referral or order," and health IT donations.