Providers and others are running into obstacles to sharing their electronic data, and the U.S. Department of Health & Human Services has not sufficiently addressed the problems, according to a new report from the Government Accountability Office.
For the report, GAO interviewed stakeholders from Georgia, North Carolina, Minnesota and Massachusetts, as well as officials within HHS. The providers outlined a myriad of challenges with interoperability and the use of health information exchanges, including insufficient health data standards that restrict or bar data exchange; difficultly keeping patient records private among states with varying requirements; matching patients to their records;, and costs associated with sharing data, including the costs of EHRs themselves.
Some providers told GAO that they would not participate in health information exchange because of the "limited opportunities" of exchanging data through such channels.
HHS has attempted to address some of these concerns, and did outline a strategy to accelerate interoperability last summer. GAO found the strategy sorely lacking, with no specific action items, no established priorities and no milestones to measure progress.
"HHS and providers have made some progress toward addressing challenges reported by providers and others related to the electronic exchange of health information, but these challenges are complex and difficult to address and are likely to continue to persist," the report's authors said. "According to CMS and [Office of the National Coordinator for Health IT] officials, ensuring progress in providers' ability to electronically exchange information is critical for the effective implementation of the EHR programs. Without a sufficient focus on exchange--including specific, prioritized actions with milestones and time frames--CMS and ONC run the risk that the desired outcomes of the EHR programs of improved quality, efficiency, and patient safety will be compromised."
GAO recommended that HHS prioritize specific actions and develop milestones, to which HHS, CMS and ONC concurred.
Interoperability of electronic patient information is a critical component of the Meaningful Use program, but it has been stymied by a host of problems. Several members of Congress have called for interoperability to be required by 2017.
To learn more:
- read the report (.pdf)