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Enhanced IT Infrastructure Key Element in Healthcare Interoperability

A cost-effective, enhanced IT infrastructure is one of the key elements outlined in a new report laying out an agenda to promote healthcare interoperability.

IT infrastructure

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By Fred Donovan

- A cost-effective, enhanced IT infrastructure is one of the key elements outlined in a new report laying out an agenda to promote healthcare interoperability prepared by the American Hospital Association (AHA) and six other national hospital associations.

The report called for consistent employment of standards, a common vocabulary, and ‘rules of the road’ to securely connect information-sharing networks in order to improve the ability to distribute information within and across healthcare settings, between providers of care, with individuals, and within the marketplace.

This health IT infrastructure should be updated regularly to keep pace with technology changes.

“The end goal is complete data sharing via a non-proprietary, vendor-neutral data exchange platform, similar to how the country is served by cable technology,” the report stressed.

Joining AHA in preparing the report were America’s Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, Children’s Hospital Association, Federation of American Hospitals, and the National Association for Behavioral Healthcare.

The report identified five other key elements of a national healthcare interoperability agenda besides a cost-effective, enhanced infrastructure: security and privacy, efficient usable solutions, standards that work, connection beyond EHRs, and shared best practices.

“We see interoperability in action all around us. Mobile phones can call each other regardless of make, model, or operating system. The hospital field has made good headway, but it’s time to complete the job. We are united in calling for a truly interoperable system that allows all providers and patients to benefit from shared health records and data, leading to fully informed care decisions,” said AHA President and CEO Rick Pollack.

In terms of security and privacy, the report called for embedding security and privacy protections into every layer of infrastructure, including ways to validate the practices and standards of third-party apps and APIs that enable easier data sharing.

“The infrastructure also must include a mechanism for health care providers to verify that a request for information is authorized, and each entity with access to individuals’ data must be responsible for appropriately securing and using that data,” the report advised.

In terms of efficient usable solutions, the report advocated for systems supporting efficient data exchange. These systems need to support patient matching and the ability to get a complete record of the patient health history and medical care.

Patient matching has become an increasing concern for the healthcare industry. The GAO recently issued a report to Congress that stressed the need for common healthcare data standards to improve patient matching, which ensures that medical records are match to the correct patient.

In terms of standards that work, as the GAO report noted, common healthcare data standards are important for patient matching. Unfortunately, the current standards support the health IT infrastructure are incomplete, implemented inconsistently, and often differ between systems, the AHA report noted.

“There is an urgent need to coalesce around improved standards that overcome the significant gaps making communication difficult between systems,” the AHA report stressed. It supported using nonproprietary, secure APIs based on the HL7 FHIR interoperability standard.

For connection beyond EHRs, the report recommended that organizations employ tools that expand the reach of information sharing to support population health, address social determinants of health, and enable remote monitoring of patients.

“The integration of data from a wider number of sources will allow providers to become more nuanced in their care of individuals,” the report said.

Finally, the report recommended the exchange of best practices for sharing patient health records and data between providers. Healthcare stakeholders should understand the need to share instructive case studies of successful interoperability that serves the needs of patients, caregivers, and providers.

“The movement toward true, national interoperability has been underway for some time. As national hospital associations, we are united in our conviction that it is time to finish the job and grant all patients the peace of mind that comes from knowing that their health care decisions are based on the best and most complete information possible,” the report concluded.


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