Despite Federal Investments in Health IT, Data Exchange Lags

August 13, 2014 in News

Although the federal government has spent billions of dollars on efforts to boost electronic health record adoption and improve interoperability, few providers are sharing data electronically, according to a new policy brief published in the journal Health Affairs, Health Data Management reports (Slabodkin, Health Data Management, 8/13).

The brief, produced through a partnership between Health Affairs and the Robert Wood Johnson Foundation, was written by Janet Marchibroda, director of the Bipartisan Policy Center’s Health Innovation Initiative.

Policy Brief Details

Marchibroda wrote, “While the sharing of information electronically … plays a critical role in improving the cost, quality and patient experience of health care, there is very little electronic information sharing among clinicians, hospitals and other providers, despite considerable investments in health [IT] over the past five years.”

She noted that more than $24 billion in incentive payments have been doled out to eligible hospitals and professionals for the meaningful use of EHRs and an additional $2 billion has been invested in federal programs related to interoperability standards, EHR certification and health information exchange-related efforts (Health Affairs policy brief, 8/11).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

However, Marchibroda wrote that health data sharing faces several barriers, including:

  • Costs associated with health information exchange;
  • Lack of a business case;
  • Lack of standards adoption and interoperability between different systems;
  • Liability concerns; and
  • Privacy and security concerns.

For example, Marchibroda explained that because the U.S. health system is based on volume-based payment instead of outcomes- or value-based payment, “there is little financial incentive to share information across settings to reduce costs or improve the quality of care” (Health Data Management, 8/13).

Marchibroda wrote, “In order to achieve electronic information sharing, EHRs and other clinical software must be ‘interoperable’ or have the capability to exchange information using agreed-upon standards, and those providing care and services must be willing to share information.”

According to Marchibroda, the requirements for data sharing under Stage 1 of the meaningful use program have been “fairly limited” but the requirements under Stage 2 are “more robust” (Health Affairs policy brief, 8/11). Further, Marchibroda cited Stage 3 of the program as a “significant opportunity to advance the interoperability of EHR technology and electronic information sharing among providers” (Health Data Management, 8/13).

Marchibroda concluded, “Additional action is needed to provide the information foundation necessary for higher-quality, more cost-effective, patient-centered care in the United States” (Health Affairs policy brief, 8/11).

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