“Interoperability” was the topic of the day, as government officials, patients, and private sector providers participated in a hearing to discuss the challenges of health information exchange.
The hearing was sponsored by the Office of the National Coordinator for Health Information Technology (ONC) as part of the Health IT Policy Committee’s Interoperability & Health Exchange Workgroup – Governance Subgroup that is exploring the challenges of interoperability as it relates to health information exchange. The hearing featured two panels in an effort to present the most complete picture. The first panel provided the provider/payer/patient perspective by featuring representatives from insurance companies, hospital networks, doctors, and even a patient. This was then followed by a second panel that provided the perspective of exchange service providers, including Get Real Health’s CEO Mark Heaney.
Overwhelmingly the feeling of the hearing stressed the need for more cooperation, but where to start varied by panelist. Some panelists stressed the need for vendors to improve cooperation by adding features to their coding like digital signatures. Others stressed the need to lower costs in order to incorporate more hospitals. Others called on the government, both state and federal, to intensify requirements of vendors and to create a national patient identifier. Mark used his time to highlight two of the biggest challenges facing interoperability: sharing CCDAs and direct messaging. As Mark told the ONC, issues with missing sections and improper handling of null data prevent many CCDAs from becoming shareable. The lack of sharing is preventing doctors from getting accurate data and meeting crucial deadlines. Mark recommended the ONC provide tools to validate CCDA data, provide example CCDAs, and extend MU compliance testing to test for failure cases and cases with null or missing data. In regards to Direct messaging, Mark cited the failure of the receiving system to identify a sender by anything more than their email address as a barrier to establishing trust. Mark urged the ONC to require a patient identity verification function by each provider to improve trust and allow for greater Direct messaging.
Despite these challenges, Mark remains positive on the future of interoperability. “We believe that these issues are surmountable…We remain strong believers that the work done to date with CCDA and Direct standards are the correct approach for asynchronous, loosely coupled exchange between clinical systems and organizations and consumers’ applications of choice,”Mark said in closing.
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