Recently, the Office of the National Coordinator for Health Information Technology (ONC) released the 2018 Annual Update on the Adoption of a Nationwide System for the Electronic Use and Exchange of Health Information. The annual report is an opportunity for the Department of Health and Human Services (HHS) to provide an update on the progress of a nationwide health information technology (health IT) infrastructure that allows for the electronic access and use of health information.
According to the report, as of 2015, 96% of non-federal acute care hospitals and 78% of office-based physicians had adopted certified health IT. However, many of those certified health IT products lack capabilities that allow for greater innovation in how health information can be securely accessed and easily shared with appropriate members of the care team.
Current State of Health IT
Currently, most Americans receiving healthcare services now have their data recorded electronically. However, the information is not always accessible across different systems and by all users (i.e., patients, health care providers, payors).
One such problem is that despite the patient’s right to access health information about themselves via the HIPAA Privacy Rule, patients often lack access to their own health information which can hinder their ability to manage their health and shop for medical care at lower prices.
Further, health care providers often lack access to patient data at the point of care, especially when multiple health care providers maintain different pieces of the health care data picture, own different systems, or use health IT solutions purchased from different developers.
According to the report, “fully using modern computing tools is critical to advancing health care.” To that end, patients should be able to easily and securely access their own medical data on their phones, easily pulling information from multiple health care providers. When it comes to the abilities of providers and payors, they also need to be able to access multiple records across a population of payments to help inform care decisions and identify trends. Having access to health outcomes would also be beneficial to providers and payors alike.
Current Barriers
Stakeholders have communicated with HHS about some of the barriers to interoperable access to health information, including technical barriers, financial barriers, trust barriers, and business practice barriers. In addition to the barriers impeding the movement of health information, there are additional burdens that arise out of the quality reporting, documentation, administrative, and billing requirements that prescribe how health IT systems are designed.
HHS is trying to better understand from the perspective of providers and payors how these barriers and challenges impact them and is working to take action on how to address the issues.
Where Are We Headed?
The report notes that health IT developers are continuing to work with hospitals and health care providers to identify their needs and offer certified health IT that not only improves the user experience, but also includes upgrades that support interoperability. It is likely that as the ONC’s 2015 edition of certification criteria and standards continue to be implemented over the next few years, these changes will be seen.
The 21st Century Cures Act provided HHS with greater authority to enhance innovation and scientific discovery as well as expanding access and use of health information. As HHS continues to implement the Cures Act, it is likely that the government and industry will continue to work together, with an enhanced focus on open APIs, a technology that allows one software program to access the services provided by another software program. The use of APIs, therefore, can improve access to, and the exchange of, health information.
Recommendations
As is to be expected, the ONC included several recommendations in its report, including: focus on improving interoperability and upgrading technical capabilities of health IT so that patients are more securely and easily able to access and move their health information using their phones and so that providers can send, receive, and analyze patient data; increase the transparency in data sharing practices and strengthen technical capabilities of health IT so that payors can promote economic transparency and operational efficiency, which would in turn lower the cost of care and administrative costs; and prioritize improving health IT and the overall administrative burden and time inefficiencies for health care providers so they can maintain a focus on their patients, not their computers.