Chantal Worzala: Poor data sharing infrastructure plagues hospitals


WASHINGTON--Despite what she called the "remarkable" uptake of electronic health records by hospitals over the last eight years, American Hospital Association Vice President, Health Information and Policy Operations Chantal Worzala said that a lack of data sharing continues to plague the industry.

Speaking on a panel at the Office of the National Coordinator for Health IT's annual meeting in the District of Columbia on Wednesday, Worzala said the AHA hears "loud and clear" from its members that the systems they implement don't always share data.

"We still don't have the infrastructure we need to support this change," Worzala said. "It's just not a place where you can use one mechanism to meet all of your data sharing needs in an efficient and effective way."

Today, she said, hospitals frequently are engaged with two or three health information exchanges and have several "one-off" connections to information trading partners, which she called highly inefficient, expensive and limiting.

"It's sort of like saying 'well, if I want to call mom, I have to pick up the blue phone, but if I want to call my sister I have to pick up the green phone. And wait, I really needed to call my aunt, who I haven't spoken to in three years; shoot, I've got to go contract with another phone company in order to call her,'" Worzala said. "That's sort of the reality that hospitals are grappling with today."

In a letter sent Wednesday to National Coordinator for Health IT Karen DeSalvo responding to ONC's request for information regarding assessing interoperability under the Medicare Access and CHIP Reauthorization Act (MACRA), the AHA brings up many of the same infrastructure concerns. The organization recommends that ONC "expand its scope of measurement ... to include whether we have the standards, technology and infrastructure needed to support" MACRA. It also calls on ONC to develop measures about the extent to which those needs are being met.

"In the RFI, ONC proposes to measure 'exchange' and 'use' of electronic health information," AHA said. "It does not, however, seek input on how to assess whether we have the correct infrastructure to support exchange."

Additionally, given the evolution of information sharing, AHA says interoperability measurement must be more "nuanced," balancing "what we have achieved against what is currently possible, rather than a numeric cut-off."

To learn more:
- here's the AHA letter (.pdf)