The Covid-19 pandemic has underscored the importance of increasing interoperability in the health care industry: ensuring that health care data is effectively shared and reported instantaneously, without extensive additional effort.
The current weaknesses in interoperability have hampered the nation’s coordinated medical response, particularly in getting patient data to public health agencies trying to keep track of the disease and manage the response.
However, a variety of organizations, initiatives, and medical records companies are boosting efforts to increase the data exchange to help providers respond to the pandemic.
“The urgent need to better respond to the Covid-19 crisis builds on growing pressure from federal agencies and health care payers to improve information exchange to better coordinate not only patient care but public health awareness of daily case volumes in different geographies,” said Leigh Burchell, vice president for government affairs and public policy at Allscripts, a health information systems company.
The inability to share health care data through the public health infrastructure is hurting efforts to coordinate a national response to the pandemic, experts say.
“We find ourselves with a $30 billion-plus investment in EHR records, and broader digitization across the health economy,” but federal health agencies aren’t getting enough data to do an effective job, said Aneesh Chopra, president of data service provider CareJourney and former chief technology officer for the U.S. in the Obama administration, referring to the past decade’s federal incentive program to support EHR implementations by providers.
In recent months, a variety of industry initiatives have sprung up to fill shortcomings in data exchange. One such effort aims to use HL7’s Fast Health care Interoperability Resources (FHIR) to enable the automated identification of reportable health events in electronic health records systems and facilitate their transmission to state and local public health authorities. Called Electronic Case Reporting, the intent is to have the app, called eCR Now, integrated into electronic health records systems, to enable their products to automatically gather and forward data on Covid-19 patients.
In addition, the HL7 Situation Awareness for Novel Epidemic Response (SANER) Project is creating an inventory of all known Covid-19 metrics requested by national, state, and local public health authorities, supporting collective knowledge sharing while preparing a FHIR-based solution that can be used in data reporting solutions.
Reporting data to state and federal public health agencies is a heavy burden for most health organizations, exacerbated by the lack of standardized approaches and differing reporting requirements among agencies, Burchell said. One Allscripts client with hospitals in several states manually submits 18 different reports each week to multiple agencies. “And there’s very little information coming back from public health to health care providers. It’s unidirectional — they’re sending data, sometimes in emails or Excel spreadsheets because the public health agencies can’t take it any other way, but not getting any aggregated data back.”
Information exchange can also be challenging within a health care delivery system. For example, during the Covid-19 crisis, some provider networks “bolted on” external telehealth services from one vendor and then have to integrate those results into their enterprise electronic health records system. That can place an additional burden on clinicians and can hamper efficiency and data exchange. By contrast, Allscripts offers an integrated solution, which enables a physician to launch a video visit directly out of the records system, with records from the virtual encounter being integrated into a patient’s entire record.
Data sharing initiatives emerge
But various industry efforts are taking aim at interoperability, and they’re seeing significant growth in 2020 as the nation struggles with Covid.
“Interoperability initiatives such as Carequality and CommonWell are providing more information sharing capabilities, and health care organizations are increasingly taking advantage of them,” said Mariann Yeager, CEO of The Sequoia Project, a not-for-profit advocate for nationwide health information exchange. CareEquality — a network to network trust framework developed to connect data sharing networks to each other — has enabled the sharing of more than 1 billion documents, with the lion’s share being exchanged in the last 12 months.
Additionally, providers and technology solution companies are working together to increase data sharing. This year, the COVID-19 Health care Coalition has formed as a private-sector led response that brings together a variety of industry participants to support health care delivery and share data that assists in real-time insights that can improve outcomes. Among its initiatives are setting standards for federated analytics to fine-tune Covid treatment.
On a technology level, the HIMSS Electronic Health Record Association is working closely with federal agencies to map out how to best expand the necessary IT infrastructure to support new and emerging requirements for data sharing. Specifically, the EHR Association’s Covid-19 task force has been working with public health officials to clarify, which data elements are sought and find efficient ways to report that data.
The efforts of the EHR Association exemplify the industry-wide push to solve data exchange challenges posed by the pandemic, Burchell said. “It’s all hands on deck; competition between our companies just doesn’t come into it as we’re responding to the Covid challenge. We’re all trying to support our collective clients as much as we can.”