- While state health departments recognize the importance of data analytics in setting state policies and population health, lack of interoperability often prevents them from optimizing technologies, a new Leavitt Partners white paper finds.
- The consulting firm interviewed officials at health departments in Colorado, Idaho, Oklahoma, Utah and Washington to understand the challenges states face at different stages of data utilization and interoperability.
- Governance and legal challenges, such as complying with HIPAA, pose a major barrier to interoperability. The report, funded by IBM Watson which makes AI and other health products, also looked at state efforts to use machine learning and artificial intelligence.
Another challenge is the ever-changing legal and regulatory environment, the paper says. State officials expressed concern that regulatory decisions, such as the change from ICD-9 to ICD-10, are often made without regard to their impact on real-life operations.
Fragmentation is also a barrier to interoperability. State health department IT systems vary in sophistication and ease of interoperability, the paper notes. A 2016 HHS survey “revealed legacy IT systems to be one of the primary challenges, with almost one-third of respondents citing outdated, inflexible, or rigid IT systems as impediments to data sharing.”
States also face financial challenges in keeping up with IT system advances. In addition to money for system upgrades or replacements, resources are needed to train staff on use and maintenance of the systems. And even if a state’s coffers are full enough to cover a major IT investment, the political climate may lean toward more programmatic spending, the paper says.
The paper is more evidence that interoperability is a tough nut to crack and isn’t happening in most cases.
For technologies to really impact health outcomes, government and the private sector need to endorse policies that support it adoption and use, a 2017 report by the Personal Connected Health Alliance found. Key priorities include frameworks and guidelines that advance interoperability and data privacy.
The 21st Century Cures Act directed the Office of the National Coordinator to develop an interoperability framework, including a common set of exchange principles. ONC released a proposed framework in January that focused on three key areas: patient access, population-level data exchange and open and accessible APIs.