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Survey: Most Providers Say Interoperability by 2020 Not Attainable with Current Federal Policies

October 20, 2017
by Heather Landi
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The majority of healthcare providers (71 percent) believe that current federal polices, committees and regulations are not sufficient to help the country attain meaningful health IT interoperability by 2020.

Less than one-third of healthcare providers believe that current federal policies and regulations are sufficient to help the nation attain meaningful interoperability in the next three years, based on the findings of the eHealth Initiative’s 2017 Survey on Access to Patient Information.

The survey findings indicate that there is a disconnect with value-based care and regulations among healthcare provider respondents, as 71 percent report that they are very concerned about changing federal regulatory requirements and the costs associated with them, and 71 percent agree that additional federal incentives need to be created or redesigned to enable delivery system transformation.

The survey is based on responses from 107 healthcare professionals at hospitals and health systems, medical groups, health information exchanges (HIEs) and accountable care organizations (ACOs). Of the respondents, 10 percent identified themselves executive leadership, 19 percent identified as IT leadership, 11 percent were clinical staff and 10 percent identified as administrative leadership.

The survey also found that 79 percent of respondents believe that strong interoperability capabilities are a key IT requirement for a successful transition to value-based care, however, at the same time, 68 percent say that current interoperability solutions in the market are not meeting their needs as they transition to value-based care.

What’s more, 58 percent of provider respondents say they plan to increase their interoperability budgets over the next two to three years. And, providers see interoperability as having a potentially positive impact on expediting access to patient data (87 percent), closing referral loops (82 percent), enabling patient access to data from their medical records (82 percent) and identifying gaps in care during an encounter (81 percent).

During a webinar presenting the survey findings, researchers who conducted the survey said that the findings indicate a disconnect with regulations, solutions and implementation. Interoperability continues to grow in importance, but regulations are sometimes unclear or difficult to implement. And, the market is meeting the regulatory needs, which are not necessarily the business needs, the researchers pointed out.

Jennifer Covich Bordenick, CEO of the eHealth Initiative, said, “Clearly, there’s a sense that we need to get this done—this information is critical to care. There’s a strong intense desire to get there, but we’re just not there yet.”

Donald Rucker, M.D., National Coordinator for Health IT (ONC) within the U.S. Department of Health and Human Services (HHS), who gave opening remarks during the webinar, said the survey results get at the heart of the problems that the industry needs to solve.

“When ONC looks at this, a lot of our activities are guided by what Congress has asked us to do, and the 21st Century Cures Act, title IV provisions, get to the heart of driving this access on patient data,” he said.

Noting that the 21st Century Cures Act mandates providers and electronic health record (EHR) vendors to provide open application programming interfaces (APIs) “without special effort,” Rucker said, “Without special effort basically means, as a practical manner, you have to use modern interface tools for that. For the nerds in the group, that means restful web standards, JSON and FHIR resources. This is what's driving the entire smartphone economy. We're getting on board with broader industry standards. The ultimate goal is for patients to have data on their smartphones.”

Rucker noted that while HIPAA already enables patients’ access to their health data, the use of open APIs will enable real-time access. “For payers and for learning health care systems, population-level queries and access to the data are going to allow the transformation in healthcare that folks are looking for, and that I think is implied in every one of the questions in the survey,” Rucker said.

While the survey revealed that provider organizations see a positive impact from increased access to patient information, such as improved patient engagement in their care (75 percent), improving the quality of care (65 percent) and improving patient satisfaction (62 percent), the survey also found that only 9 percent were fully compliant with ONC's 2015 EHR certification with products that enable open APIs. Most respondents (41 percent) said they are in the process of implementing technology.

The providers' biggest concerns, when it comes to releasing data to third-party apps, were security and patient confidentiality, according to the report.

Overall, 40 percent of respondents said they are seeing at least a minimal increase in patients asking to see their data and 35 percent said they are seeing a moderate or major increase. When asked if patients want to provide additional information to their EHR data, 35 percent of respondents said they are seeing a minimal increase and 27 percent said they are seeing a moderate to major increase.

During the webinar, Bordenick also shared survey results about the types of information that patients want to share with other clinicians. She noted that, in some cases, patients are acting as their own HIE, such as wanting to share lab information, imaging results, prescription information, blood pressure readings and diabetes monitoring data. And, in other ways, patients are acting as data sources, as they want to share weight readings, medication adherence data and exercise data.


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