- Despite widespread EHR adoption, providers, patients and payers still face significant hurdles in accessing and sharing data, the Office of the National Coordinator for Health Information Technology says in its latest progress report to Congress.
- The 22-page report, released this week, covers the timeframe of November 2016 through October 2018. Ongoing barriers to seamless data sharing range from technical and financial to trust and business practices, ONC says.
- Quality reporting, documentation, administrative and billing requirements that dictate how health systems are designed also hinder the practical use of health IT, according to the report.
ONC notes that with 96% of nonfederal acute care hospitals and 78% of office-based physicians having adopted certified health tech as of 2015, "most Americans who receive care now have their health data recorded electronically." The report adds: "However, this information is inaccessible across systems and appropriate end users in the market in ways that can generate value."
The department notes, for example, that healthcare end users lack common tools for securely accessing easily sharing information available in other industries. Lack of transparency around expectations for data sharing and frustration among providers over barriers to use also limit return on investment and undermine the value they and patients get from certified EHRs.
"Currently, patients electronically access their health information through patient portals that prevent them from easily pulling from multiple sources or health care providers," the report notes. Accessing information also requires repeated logins and manual data updates.
Lack of interoperability forces providers and payers to access one record at a time, limiting their ability to aggregate data for research or claims purposes. It also limits information on health outcomes and the ability to compare providers based on quality and value of care. "Outcome data will allow payers to apply machine learning and artificial intelligence to have better insight into the value of the case they purchase," the report adds.
ONC previously reported that 78% of nonfederal acute care hospitals are sending patient summary of care records to outside organizations, while 74% receive such reports. Yet fewer than half of hospitals (41%) claimed the ability to perform in all four interoperability domains: send, receive, find and integrate.
The new report comes as the healthcare industry is still awaiting ONC's rule to curb information blocking, which sailed past a 90-day deadline for Office of Management and Budget review in mid-December.
ONC sent the proposed rule to clarify information blocking under the 21st Century Cures Act to OMB on Sept. 17, after missing a previous release target of April 2108. Failure to meet the December deadline has renewed industry criticism about the drawn-out delay. And with OMB employees furloughed by the government shutdown, there's no telling when the required review of the rule will be complete.
Meanwhile, nearly a third of health IT developers preparing to meet 2015 edition EHR certification requirements are using the Fast Health Interoperability Resources standard, specifically FHIR Release 2.
To move things along, HHS recommends healthcare organizations focus on improving health IT interoperability and technical capabilities so that patients can securely access, amass and transfer health information via their mobile devices and providers can easily send, receive and analyze patient data.
HHS also calls for better transparency and technical capabilities to enable payers to access population-level clinical data, increasing operational efficiencies and lowering costs. Finally, the report urges renewed efforts to reduce administrative burdens around documentation and time inefficiencies that constrict doctors' time with their patients.