Though health information exchanges hold the potential to improve benchmarking, efficiency, and ultimately, quality of care in oncology, much remains to be done to make that happen, according to a report from the Association of Community Cancer Centers (ACCC).
The whitepaper, "Cancer Care in the Age of Electronic Health Information Exchange," grew out of discussion at the ACCC Institute for the Future of Oncology forum in June.
The promise of improving care coordination is especially pertinent in cancer care, which involves multiple services, from multiple specialists, in multiple locations, the whitepaper argues.
Adoption and integration of electronic health records has been the first step; the second is adoption and engagement with HIEs. In the ACCC's 2013 Trends in Community Centers survey, 79 percent of respondents reported using EHRs.
Among the pertinent points from the discussion, according to an announcement:
- HIE adoption is uneven. Participants voiced concern that exchange is happening only within some health systems in certain parts of the country. They expressed concern with information "silos," with some providers and patients left in the dark. There is no single model for HIEs. Not only is there geographical variance in availability of HIEs across the country, there is great variation in how HIEs work, such as the services they provide, the cost of participation and the benefits to participants.
- There is a surprising lack of awareness around HIEs.
- HIE initiatives must focus on information standardization.
- Interoperability challenges remain in data sharing while ensuring privacy and security
- HIEs can help benchmark interventions within patient populations.
- Portals offer an important avenue for patient empowerment and engagement, but providers must have input on the information released and its timing. Participants raised concerns that patients might misinterpret information and that it might cause unnecessary distress or worry. One provider organization has delayed release of information to ensure a patient visit is scheduled, so the doctor can discuss test results with the patient. Participants were worried that Meaningful Use requirements will give physicians less control of the information released through the patient portal.
Participants voiced a need for more information about HIEs, best practices and resources.
EHRs are helping physicians progress in their ability to share data electronically, but capability still varies widely, the Office of the National Coordinator of Health IT reported recently.
At the American Health Information Management conference in Atlanta, the new Commonwell Health Alliance of health IT companies named its three biggest HIE hurdles: patient matching, data access and cost issues.