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Role of Provider Engagement for Improving Data Accuracy – #HITsm Chat Topic

Posted on October 10, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 10/13 at Noon ET (9 AM PT). This week’s chat will be hosted by @CAQH on the topic of “Role of Provider Engagement for Improving Data Accuracy.”

Healthcare provider data forms the foundation of many important processes in the nation’s healthcare system, whether referring a patient to a specialist, paying insurance claims, credentialing providers or maintaining accurate provider directories. Yet access to accurate, timely provider data has remained elusive.

A lack of authoritative and reliable sources has resulted in a costly, piecemeal approach to acquiring and maintaining provider information. The commercial healthcare industry spends at least $2.1 billion annually on inefficient processes to maintain the data, according to a recent CAQH white paper.

While healthcare providers are important contributors of their professional and practice information, the task of submitting frequent updates to different organizations, through different channels, has created a significant administrative challenge.

Join @CAQH in a discussion about the role of provider engagement in improving data accuracy. Topics will cover strategies for collaboration and enhanced communication to ease the burdens on providers and users of provider data.

Reference Materials:

Topics for This Week’s #HITsm Chat:

T1: Stakeholders define provider data differently. How do you use provider data & in what role, i.e. payer, provider, consumer? #hitsm

T2: How does the shifting definition of “provider” (e.g. emerging provider types) impact data management? #hitsm

T3: How can the industry empower providers to participate more actively in data accuracy? #hitsm

T4: What can industry stakeholders do to reduce the administrative burden on providers? #hitsm

T5: What strategies would help providers and payers hold each other accountable for high-quality provider data? #hitsm

BONUS: What is the biggest opportunity you see for improving the quality of provider data right now? #hitsm

Upcoming #HITsm Chat Schedule
10/20 – Community Sharing Chat
Hosted by the #HITsm Community

10/27 – Aggregating the Patient Perspective and Incorporating It Into Software to Change Healthcare
Hosted by Lisa Davis Budzinski (@lisadbudzinski)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

After Death Data Donation – A #hITsm Halloween Horror Chat

Posted on October 3, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 10/6 at Noon ET (9 AM PT). This week’s chat will be hosted by Regina Holliday (@ReginaHolliday), Founder of #TheWalkingGallery on the topic of “After Death Data Donation.”

Since this month is October (which is heavily associated with death and horror in western cultures) and this week is National HIT week, I thought we would combine the two and talk about death and data donation. Since the 1970’s the autopsy rate in the US has plummeted to less than 10%. When the results of the autopsies are evaluated, in 30% cases the cause of death on the death certificate is a misdiagnosis.

In EHR data collection, the system is designed to capture data of a live patient and data collection stops once a patient dies. Let’s explore these topics in this week’s #hITsm Twitter chat.

References:

Here are the questions that will serve as the framework for this week’s #HITsm chat:
T1: How can we create a system that provides more access to autopsies? #HITSM

T2: How do we collect autopsy data through the EHR for quality control and public health? #HITsm

T3: How do we change a status quo that is willing to look the other way when faced with the reality of poor data about death? #HITsm

T4: How can we make after death data donation a reality for patient families? #HITsm

T5: Some states still have their autopsy data in paper systems. Does ONC need a meaningful use for a meaningful death? #HITsm

Bonus: The CDC did a great job reminding folks about disaster preparedness with their Zombie campaign. Can the do something like that to highlight the need for cause of death data? #HITsm

Upcoming #HITsm Chat Schedule
10/13 – Role of Provider Engagement for Improving Data Accuracy
Hosted by @CAQH

10/20 – Community Sharing Chat
Hosted by the #HITsm Community

10/27 – Aggregating the Patient Perspective and Incorporating It Into Software to Change Healthcare
Hosted by Lisa Davis Budzinski (@lisadbudzinski)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Why Should Patients Control Their Health Data? Here Are A Few Ideas.

Posted on September 29, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Lately, healthcare organizations have begun working to give patients more access to their personal health data. They’ve concluded that the more control patients have, the more engaged they become in your care, which in turn leads to better outcomes.

But patient engagement isn’t the only reason for giving patients the keys to their PHI. In fact, organizational control of patient health data can cause problems for everyone in the healthcare data exchange chain.

An item found on the Allscripts blog does a nice job of articulating issues that can arise.  According to the blog item, those issues include the following:

  • The patient is in the best position to address inconsistencies in their medical record. For example, if one doctor diagnoses the patient with asthma, then another physician conclusively demonstrates the patient is not asthmatic, the patient can reconcile the two physicians’ conclusions.
  • Patients have a better overview of their care than most doctors. When a chronically ill patient sees multiple clinicians, their impressions may conflict with one another, but the patient can provide context on their overall conditions.
  • If a patient consents to multiple uses of their health data, and the consents seem to be in conflict, only the patient can articulate what their intentions were.
  • If the master patient indexing process generates a false match with someone else’s records, the patient will recognize this immediately, while physicians may not.
  • Giving patients control of the record allows them to decide how long those records should be maintained. Otherwise, HIEs — or other entities not bound by record retention laws — might destroy the data prematurely.
  • When patients have control of their data, they can make sure it gets to whomever they choose. On the other hand, patient data may not make it to other care settings if providers drop the ball.

To be sure, delegating control of their PHI to patients can go too far.

For example, if they’re transmitting most or all of their health data between providers, it could pose a significant administrative burden.  Patients may not have the time or energy to route the data files between their providers, assure that data has been received on the other end and make certain that the data was formatted in a way their clinicians can use.

Also, if the patient is chronically ill and sees multiple providers, they may end up having to manage a large body of data files, and not everyone can do so effectively. Ultimately, they may get too overwhelmed to send their records to anyone, or send the wrong records, which can create complications of its own.

Still, on the whole, healthcare organizations are giving patients more control of their health data for good reasons. When patients take responsibility for their health data, they’re far more likely to understand their condition and take steps to address problems. Establishing a balance between patient and provider control may be tricky, but it can and should be done.

NY-Based HIE Captures One Million Patient Consents

Posted on September 28, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

One of the big obstacles to the free exchange of health data is obtaining patient consent to share that data. It’s all well and good if we can bring exchange partners onto a single data sharing format, but if patients don’t consent to that exchange things get ugly. It’s critical that healthcare organizations solve this problem, because without patient consent HIEs are dead in the water.

Given these issues, I was intrigued to read a press release from HEALTHeLINK, an HIE serving Western New York, which announced that it had obtained one million patient consents to share their PHI. HEALTHeLINK connects nearly 4,600 physicians, along with hospitals, health plans and other healthcare providers. It’s part of a larger HIE, the Statewide Health Information Network of New York.

How did HEALTHeLINK obtain the consents? Apparently, there was no magic involved. The HIE made consent forms available at hospitals and doctors’ offices throughout its network, as well as making the forms available for download at whyhealthelink.com. (It may also have helped that they can be downloaded in any of 12 languages.)

I downloaded the consent form myself, and I must say it’s not complicated.

Patients only need to fill out a single page, which gives them the option to a) permit participating providers to access all of their electronic health information via the HIE, b) allow full access to the data except for specific participants, c) permit health data sharing only with specific participants, d) only offer access to their records in an emergency situation, and e) forbid HIE participants to access their health data even in the case of an emergency situation.

About 95% of those who consented chose option a, which seems a bit remarkable to me. Given the current level of data breaches in news, I would’ve predicted that more patients would opt out to some degree.

Nonetheless, the vast majority of patients gave treating providers the ability to view their lab reports, medication history, diagnostic images and several additional categories of health information.

I wish I could tell you what HEALTHeLINK has done to inspire trust, but I don’t know completely. I suspect, however, that provider buy-in played a significant role here. While none of this is mentioned in the HIE’s press release or even on its website, I’m betting that the HIE team did a good job of firing up physicians. After all, if you’re going to pick someone patients would trust, physicians would be your best choice.

On the other hand, it’s also possible patients are beginning to get the importance of having all of the data available during care. While much of health IT is too abstruse for the layman (or woman), the idea that doctors need to know your medical history is clearly beginning to resonate with your average patient.

Condition Management vs. Episodic Care Management – #HITsm Chat Topic

Posted on September 26, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 9/29 at Noon ET (9 AM PT). This week’s chat will be hosted by Brian Eastwood (@Brian_Eastwood) from @ChilmarkHIT on the topic of “Condition Management vs. Episodic Care Management.”

The status quo of episodic care management – static care plans that rely heavily on high-touch interventions – is unsustainable if the healthcare industry truly intends to lower costs and improve outcomes. In response, the industry has seen growing interest in digital chronic condition management programs that take a more holistic and individualized approach to care. By and large, these programs use short but frequent interventions that aim to address the root causes of a condition, rather than just the symptoms themselves, in an effort to help program participants manage their condition(s) and improve their quality of life.

Given the current market, health insurers and employers are more interested in adopting condition management programs that provider organizations. This isn’t surprising – employers and insurers have clear “skin in the game” to cut costs, and providers do not – but it is nonetheless disappointing. This week’s #HITsm chat will discuss what it will take for condition management programs to gain the interest of those who deliver care, not just those who pay for care.

References:

  • Assessing the Growing Market for Condition Management Solutions: Blog post and webinar
  • Condition Management: A Healthcare Disruption That Just Might Stick: Blog post

Here are the questions that will serve as the framework for this week’s #HITsm chat:
T1: What are the key drawbacks to static condition mgmt. (both tech and workflow)? #HITsm

T2: What does holistic condition mgmt. do that episodic care mgmt. doesn’t? #HITsm

T3: How can condition mgmt. show that it’s not just a “wellness program” in new clothes? #HITsm

T4: Aside from payment reform, what will it take for provider orgs to pivot to condition mgmt.? #HITsm

T5: Where do you see the market for holistic condition mgmt. in the next 3 years? #HITsm

Bonus: Which vendors or orgs are getting condition mgmt. right? #HITsm

Upcoming #HITsm Chat Schedule
10/6 – After Death Data Donation – A #hITsm Halloween Horror Chat
Hosted by Regina Holliday (@ReginaHolliday), Founder of #TheWalkingGallery

10/13 – Role of Provider Engagement for Improving Data Accuracy
Hosted by @CAQH

10/20 – Community Sharing Chat
Hosted by the #HITsm Community

10/27 – Aggregating the Patient Perspective and Incorporating It Into Software to Change Healthcare
Hosted by Lisa Davis Budzinski (@lisadbudzinski)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Public Health Agencies Struggle To Integrate With HIEs

Posted on September 21, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

New research by ONC suggests that while public health agencies might benefit from connecting with HIEs, there are still some significant barriers many need to address before doing so.

Public health agencies at both the state and local level collect information from providers as part of conducting disease surveillance activities and maintaining data registries. Though some of these registries are common – notably those focusing on childhood immunizations, birth defects and cancer—the agencies’ technical infrastructure and data formats still vary. This makes sharing data between them difficult.

One alternative to cumbersome data matching between agencies is for the agencies to integrate with an HIE. According to the ONC report, public health researchers have begun to find that at least some of the time, the data they get from HIE organizations is richer than data from clinical systems. Not only that, when public health agencies integrate their information systems with HIEs, it can help them conduct many of their functions more effectively. However, it’s still unusual to find HIE-connected agencies as of yet.

In its new report, ONC outlines what it learned about what the agencies hoped to accomplish with HIE integration and how they moved ahead with integration. To find this out, ONC contracted with Clinovations Government + Health, which participated in discussions with eight entities and analyzing more detailed information on 10 others.

Virtually all respondents had two goals for HIE integration: 1) Minimizing the number of connections needed to link providers, HIEs and agencies and 2) Helping providers meet public health requirements for Medicare and Medicaid EHR incentive programs. A small subset also said that over the longer term, they wanted to create a sustainable platform for clinical and public health exchange which could support enhanced analytics and quality measurement.

Not surprisingly, though, they face considerable challenges in making HIE integration actually happen. In most cases, technology issues were possibly the toughest nut to crack, and almost certainly the most complex. To connect with an HIE, agencies may confront incompatible transport and messaging protocols, standards problems, data classification and coding issues, inconsistent data quality, and their often-inflexible legacy systems, to name just a few of the many problems ONC cites.

As if that weren’t enough, the agencies may not have the funding in place to take on the integration effort, and/or lack a stable funding stream; don’t have the kind of cross-functional leaders in place needed to integrate their systems with HIEs; grapple with complicated patient data privacy and security issues; and bump up against state laws limiting data sharing methods.

However, through its research, the ONC did gather some useful feedback on how the agencies were coping with the long list of HIE integration challenges they face. For example, to win over the support of policymakers, some agencies have emphasized that they’ll be able to use HIE data for higher-level analytics and quality measures. The respondents also noted that HIE integration got more internal support when they got buy-in from top leaders and second-tier leaders have project management, technical and policy skills.

Given these odds, it’s little wonder that the number of public health agencies successfully integrating with HIEs is still small. That being said, there’s good reason for them to keep pushing for integration, so their number is likely to grow over the next few years.

The Impact of HIEs in Natural Disasters – #HITsm Chat Topic

Posted on September 19, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 9/22 at Noon ET (9 AM PT). This week’s chat will be hosted by Brian Mack (@BFMack) from @GLHC_HIE on the topic of “The Impact of HIEs in Natural Disasters.”

On August 29th, 2005, Hurricane Katrina, a category 3 storm, made landfall in SE Louisiana. Torrential rain and sustained winds exceeding 110 MPH quickly overwhelmed the protective measures in place, and the subsequent storm surge breached levies and flooded huge swaths of New Orleans and surrounding areas. Mass-devastation across Louisiana and Mississippi contributed to the deaths of nearly 1,500 people, forced tens of thousands more from their homes, and caused an estimated $108 billion in property damage. At that time, only 10% of physicians were actively using electronic medical records, and electronic health information exchange was still was in its infancy. An incalculable number of paper health records were lost forever. The lack of access to patient information during and following the storm significantly hindered medical response efforts, and required years to replace.

Fast forward to Aug. 24th-26th, 2017, when Hurricane Harvey, an even larger (Cat. 4) storm struck Southern Texas, and dumped more than 40 inches of rain on the greater Houston area. While Harvey has been described as “Houston’s Katrina” in terms of its intensity and impact, the story was significantly different for the healthcare delivery system. Two health information exchanges in the region, the Greater Houston Healthconnect (GHHC) and Healthcare Access San Antonio (HASA) worked together to assist both those who stayed through the storm, as well as those who were evacuated. GHHC staff actually shuttled between shelters in the Houston area, overseeing the set-up of HIE portals, to help clinicians provide care for patients. Providers were able to maintain access to patient records, even from remote locations, using laptops and WiFi to access EHR systems in the normal way. As a result, the response to medical needs, and continuity of care for the population impacted by Harvey across Texas was seamlessly maintained at a very high level.

This week’s #HITSM Twitter chat will discuss the opportunities, challenges, and value of community-based Health Information Exchange in connecting the “last mile” of interoperability, particularly in emergency situations.

Some additional reading:

Here are the questions that will serve as the framework for this week’s #HITsm chat:
T1: What lesson(s) should we, as participants in the healthcare ecosystem, take away from events like Hurricanes Katrina & Harvey? #HITsm

T2: What roles do/should stakeholders: government (local, state, federal), HC providers, private sector, citizenry play in assuring adequate preparation for disasters? #HITsm

T3: What responsibilities do health IT infrastructure vendors (EHR), and Health Information Exchange have in supporting successful emergency response? #HITsm

T4: How do community based HIE’s differ from national interoperability efforts and/or vendor based solutions in emergency situations? #HITsm

T5: What examples from your own local communities can you share where community-based health information exchange either made a difference, or COULD have made a difference in responding to a public emergency? #HITsm

Bonus: Aside from the basic task of networking disparate healthcare providers, how could Health Information Exchange contribute to better connected communities? #HITsm

Upcoming #HITsm Chat Schedule
9/29 – Condition Management vs Episodic Care Management
Hosted by Brian Eastwood (@Brian_Eastwood) from @ChilmarkHIT

10/6 – After Death Data Donation – A #hITsm Halloween Horror Chat
Hosted by Regina Holliday (@ReginaHolliday), Founder of #TheWalkingGallery

10/13 – Role of Provider Engagement for Improving Data Accuracy
Hosted by @CAQH

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

DirectTrust, CHIME Deal Not All It’s Cracked Up To Be

Posted on September 7, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Recently, CHIME and DirectTrust announced a deal that sounded pretty huge on the surface. In a joint press release announcing the agreement, the two organizations said they had agreed to work together “to promote the universal deployment of the Direct Trust framework and health information exchange network as the common electronic interface for health information exchange across the U.S.”

Their plans include making the Direct exchange network available anywhere they can, including hospitals, medical practices, pharmacies, labs, long-term care facilities, payers, insurers and health departments, and to top it off, on applications. If things go the way they planned, you’ll hardly be able to kick a health IT rock without finding Direct under it.

As I noted earlier this year, DirectTrust is on something of a roll. In May, it noted that the number of health information service providers who engaged in Direct exchanges grew to almost 95,000 during the first quarter of this year. That’s a 63% increase versus the same period in 2016. The group also reported that the number of trusted Direct addresses which could share PHI grew 21%, to 1.4 million, and that there were 35.6 million Direct exchange transactions during the quarter, up 76% over the same period last year.

Sounds good. But let’s not judge this in a vacuum. For example, on the same day DirectTrust released its first quarter results, the Sequoia Project kicked out a press release touting its performance. In the release, Sequoia noted that its Carequality initiative was under full steam, with more than 19,000 clinics, 800 hospitals and 250,000 providers using the Carequality Interoperability Framework to share health data.

In considering the impact of Carequality, let’s not forget that late last year it connected with rival interoperability group CommonWell Health Alliance. I don’t know if you can say that interoperability effort can corner a market– the organizations using the rival health data sharing networks probably overlap substantially—but it’s certainly an interesting development. While the two organizations were both allied with a leading EMR vendor (CommonWell with Cerner and Carequality with Epic), the agreement has effectively brought the muscle of the two EMR giants together.

I guess it’s fair to say that the Carequality alliance and DirectTrust may own interoperabililty for now, rivaled only by the stronger regional HIEs.  That’s pretty impressive, I admit. Also, it’s interesting to see an accepted health IT organization like CHIME throw its weight behind Direct. I wouldn’t have expected CHIME to dive in here.

That being said, when you get down to it, none of the groups’ capacity for sharing health data is as great as it sounds. For example, if Epic’s Care Everywhere exchange only transmits C-CDA records, you have to ask yourself if Carequality is working at a higher level. If not, we’re in “meh” territory.

Bottom line, it seems clear that these organizations are winning the battle for interoperability mindshare. Both seem to have made a fair amount of progress. But between you and me in the lamppost, let’s not get excited just yet.

Direct, Sequoia Interoperability Projects Continue To Grow

Posted on May 15, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

While its fate may still be uncertain – as with any interoperability approach in this day and age – the Direct exchange network seems to be growing at least. At the same time, it looks like the Sequoia Project’s interoperability efforts, including the Carequality Interoperability Framework and its eHealthExchange Network, are also expanding rapidly.

According to a new announcement from DirectTrust, the number of health information service providers who engaged in Direct exchanges increased 63 percent during the first quarter of 2017, to almost 95,000, over the same period in 2016.  And, to put this growth in perspective, there were just 5,627 providers involved in Q1 of 2014.

Meanwhile, the number of trusted Direct addresses which could share PHI grew 21 percent, to 1.4 million, as compared with the same quarter of 2016. Again, for perspective, consider that there were only 182,279 such addresses available three years ago.

In addition, the Trust noted, there were 35.6 million Direct exchange transactions during the quarter, up 76 percent over the same period last year. It expects to see transaction levels hit 140 million by the end of this year.

Also, six organizations joined DirectTrust during the first quarter of 2017, including Sutter Health, the Health Record Banking Alliance, Timmaron Group, Moxe Health, Uticorp and Anne Arundel Medical Center. This brings the total number of members to 124.

Of course, DirectTrust isn’t the only interoperability group throwing numbers around. In fact, Seqouia recently issued a statement touting its growth numbers as well (on the same day as the Direct announcement, natch).

On that day, the Project announced that the Carequality Interoperability Framework had been implemented by more than 19,000 clinics, 800 hospitals and 250,000 providers.

It also noted that its eHealth Exchange Network, a healthcare data sharing network, had grown 35 percent over the past year, connecting participants in 65 percent of all US hospitals, 46 regional and state HIEs, 50,000 medical groups, more than 3,400 dialysis centers and 8,300 pharmacies. This links together more than 109, million patients, Sequoia reported.

So what does all of this mean? At the moment, it’s still hard to tell:

  • While Direct and Sequoia are expanding pretty quickly, there’s few phenomena to which we can compare their growth.
  • Carequality and CommonWell agreed late last year to share data across each others’ networks, so comparing their transaction levels to other entities would probably be deceiving.
  • Though the groups’ lists of participating providers may be accurate, many of those providers could be participating in other efforts and therefore be counted multiple times.
  • We still aren’t sure what metrics really matter when it comes to measuring interoperability success. Is it the number of transactions initiated by a provider? The number of data flows received? The number of docs and facilities who do both and/or incorporate the data into their EMR?

As I see it, the real work going forward will be for industry leaders to decide what kind of performance stats actually equate to interoperability success. Otherwise, we may not just be missing health sharing bullseyes, we may be firing at different targets.

Study: “Information Blocking” By Vendors And Providers Persists

Posted on April 6, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A newly-released study suggests that both EHR vendors and providers may still be interfering with the free exchange of patient healthcare data. The researchers concluded that despite the hearty disapproval of both Congress and healthcare providers, the two still consider “information blocking” to be in their financial interest.

To conduct the study, which appears in this month’s issue of The Milbank Quarterly, researchers conducted a national survey between October 2015 and January 2015. Researchers reached out to leaders driving HIE efforts among provider organizations. The study focused on how often information blocking took place, what forms it took and how effective various policy strategies might be at stopping the practice.

It certainly seems that the practice continues to be a major issue of concern to HIE leaders. Eighty-three percent of respondents said they were very familiar with information blocking, while just 12 percent reported having just some familiarity with the practice and 5 percent said they had minimal familiarity. On average, the respondents offered a good cross-industry view, having worked with 18 EHR vendors and with 31 hospitals or health systems on average.

Forms of Blocking:

If the research is accurate, information blocking is a widespread and persistent problem.

When questioned about specific forms of information by EHR vendors, 29 percent of respondents said that vendors often or routinely roll out products with limited interoperability capabilities. Meanwhile, 47 percent said that vendors routinely or often charge high fees for sharing data across HIEs, and 42 percent said that the vendors routinely or often make third-party access to standardized data harder than it needs to be. (For some reason, the study didn’t mention what types of information blocking providers have instituted.)

Frequency of blocking:

It’s hardly surprising that most of the respondents were familiar with information blocking issues, given how often the issue comes up.

In fact, a full fifty percent said that EHR vendors routinely engaged in information blocking, 33 percent said that the vendors blocked information occasionally, with only 17 percent stating that EHR vendors rarely did so.

Interestingly, the HIE managers said that providers were also engaged in information blocking, though fewer did so than among the vendor community. Twenty-five percent reported that providers routinely engage in information blocking, and 34 percent saying that providers did so occasionally. Meanwhile, 41 percent said information blocking by providers was rare.

Motivations for blocking:

Why do HIE participants block the flow of health data? It seems that at present they get something important out of it, and unless somebody stops them it makes sense to continue.

When it came to EHR vendors, the respondents felt that their motivations included a desire to maximize short-term revenue, with 41 percent reporting that this was a routine motivation and 28 percent that it was an occasional motivation. They also felt EHR vendors blocked information to improve the chances that providers would choose their platform over competing products, with 44 percent of respondents saying this was routine and 11 percent that it was occasional.

Meanwhile, they believed that hospitals and health systems, the most common motivation was to improve revenue by strengthening their competitive advantage, with 47 percent seeing this as routine and 30 percent occasional. Also, respondents said providers wanted to accommodate priorities other than data exchange, with 29 percent seeing this as routine and 31 percent occasional.

Solutions:

So what can be done about vendor and provider information blocking? There are a number of ways policymakers can get involved, but few have done so as of yet.

When given a choice of policy-based strategies, 67 percent said that making this practice illegal would be very effective. Meanwhile, respondents said that three strategies would be very or moderately effective. They included prohibiting gag clauses and encouraging public reporting and comparisons of vendors and their products (93 percent); requiring stronger demonstrations of product interoperability (92 percent) and national policies defining policies and standards for core aspects of information exchange.

Meanwhile, when it came to reducing information blocking by providers, respondents recommended that CMS roll out stronger incentives for care coordination and risk-based contracts (97 percent) and public reporting or other efforts shining a spotlight on provider business practices (93 providers).