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Will Personal Health Information Exchanges (PHIE) Lead the Consumer Medical Record Revolution and Bridge the Gap Between PHRs and EHRs? (Part 2 of 2)

Posted on August 5, 2015 I Written By

The following is a guest blog post by Cora Alisuag, RN, MN, MA, CFP, President & CEO, CORAnet Solutions, Inc.
Cora Alisuag, CEO, CORAnet Solutions
Be sure to check out part 1 in this series where we talked about the movement towards an empowered patient who controls their health record.

Lack of Interoperability Continues to Hamper Patient Record Access

However, it has been six years since the HITECH Act passed, yet most Americans seeking medical care are still unable to obtain their full medical records for a variety of reasons. Some hospitals will simply not release them or proprietary EHR system vendors not allowing hospitals, let alone patients, direct access.

This capability also comes at a critical time as enormous obstacles hamper the ability of people to obtain their medical records. This is documented in the ONC’s “2015 Report to Congress on Health Information Blocking” which concludes that it is apparent that some health care providers and health IT developers are knowingly interfering with the exchange of health information in ways that limit its availability and use to improve health and health care.

This situation is only going to worsen as the Centers for Medicaid and Medicare (CMS) is considering a change to the EHR meaningful use rule that requires five percent of patients must view or download or transmit their health data to only one patient; not one percent, one patient.

Blue Button Not Gaining traction

In the meantime, other PHR technology has been introduced, but has not gained popularity including forays from Microsoft and Google. The ONC and other government organizations’ initiative to adopt and use the Blue Button platform for exchanging healthcare data between clinicians equipped with electronic health-record systems and patients with mobile computing devices is stalled, according to a recent survey by the not-for-profit Workgroup for Electronic Data Interchange (WEDI).

WEDI questioned 274 providers, health plans, HIT vendors and claims clearinghouses in the Second Annual Survey of Industry Awareness of Blue Button, conducted late in 2014. Only eight percent of respondents noted that their organizations actually used Blue Button, down from 15% of survey respondents in 2013.

PHRs Largely Unpopular

PHRs joined the lexicon of medical terminology several years ago as a convenience way for consumers to have copies of their medical records. It was largely born out of EHR’s lack of interoperability and access. However, as far back as 2009, a Health Affairs article detailed the major factors behind the slow adoption of PHRs. The article reviewed some of the reasons and includes cost, access, interoperability, security concerns, and data ownership.

Because health records which include clinical data, laboratory results and medical images do not flow freely among multiple organizations due to lack on EHR interoperability, PHRs do not automatically receive data. This means that the data must often be entered manually by consumers—a time-consuming and error-prone process. For most consumers, this lack of safe and reliable automation makes it problematic to maintain a PHR, and a PHR that is not up-to-date likely will not be used. Unlike PHIEs, the API-EHR connectivity connection is the missing link in PHRs.

However, the authors of the Health Affairs article offered a challenge. They described a gap between today’s personal health records (PHRs) and what patients say they want and need from this electronic tool for managing their health information. They noted that until that gap is bridged, it is unlikely that PHRs would be widely adopted, but noted that in the future; when these concerns are addressed, and health data is portable and understandable in content and format, PHRs will likely prove to be invaluable.

“While we all agree that lack of interoperability continues to stymie patient health record access and PHRs might not be the ultimate solution, but if a PHIE can bridge the gap by accessing EHR data through an open API while offering the security and convenience of a PHR. I believe PHIEs offer a solution that should satisfy the spontaneity of millennials’ and more frequent use of middle-aged and elderly users,” says Tiffany Casper, RNC, CNM, MSN and President of EMR Consultants which helps medical organizations transition to EMR systems.

About Cora Alisuag
Cora Alisuag is the CEO of CORAnet Solutions, Inc., a health information technology company. She is the inventor of CORAnet technology, the software engine that drives CORAnet’s Personal Health Information Exchange (PHIE), allowing patients’ mobile device access to their complete medical records. She is also an MN, MA, CFP and healthcare industry speaker and serial medical entrepreneur.

Vendors Way (Seriously, Way) Behind In ICD-10 Readiness

Posted on December 23, 2013 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 providers are well aware that the consequences of failing to be ready for ICD-10 in time can be dire, that hasn’t kept them on track. In fact, according to a new report, providers have fallen further behind with ICD-10 milestones that they did back in February, reports Healthcare IT News.

But as you will see, it’s not necessarily the providers’ fault. In fact, if I were a provider, and my vendor was as behind as some apparently are right now, I would be beside myself.

Research from the Workgroup for Electronic Data Interchange found that some 50 percent of providers have completed the ICD-10 impact assessments. And about 50 percent of providers expect to begin external testing in the first half of 2014, Healthcare IT News notes.

But the study concludes that about 80 percent of healthcare providers will fail to complete their business changes and testing ICD-10 before 2014.

This may not be their fault. According to WEDI, 20 percent of vendors surveyed said they were halfway there or less developing products to support ICD-10. Even worse, 40 percent indicated they wouldn’t even have a finished product available until sometime in mid-2014, a situation which could create enormous problems for providers. (Wondering vendors are addressing the changeover? Here’s how one vendor has been handling the  problem.)

According to WEDI, the top three barriers to vendors completing their ICD-10 upgrades were customer readiness, competing priorities and other regulatory mandates. Personally, I’d argue that vendors have had plenty of time to get the ICD-10 act together. And I wouldn’t find any of those excuses compelling given the impact these delays are likely to have on my operations – – specifically, that special part of operations known as getting paid.  (But hey, maybe you’re a more forgiving type than me.)

With vendors falling behind on ICD-10 software updates and patches, providers are left having to wait — way too long — to begin tests of the downstream functions to come after testing, Judy Comitto, CIO at Trinitas Regional Medical Center in New Jersey, told Healthcare IT News: “I’m a bit disappointed, having reached out to these vendors that they are certainly not there yet.”  Sadly, I think more disappointment is yet to come.