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Lack of HIT Interoperability Leaves Infrastructure Gaps

Report states that lack HIT infrastructure interoperability leaves gaps preventing clinicians and patients from fully embracing healthcare technology.

Poor HIT infrastructure interoperability prevents clinicians and patients from fully embracing technology.

Source: Thinkstock

By Elizabeth O'Dowd

- HIT infrastructure has yet to evolve to truly support the transition so value-based care due to lack of HIT interoperability, according to a recent report from the Journal of the American Medical Informatics Association (JAMIA).

The report acknowledged the progress made in the effort to digitize healthcare over the past several years, but found that most health IT infrastructures are still made up of separate systems that don’t work together to meet the demands of value-based care. The lack of interoperability makes it difficult for providers and patients to fully utilize technology.

“Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed. The result is a chasm between the current health IT ecosystem and the health IT ecosystem that is desperately needed,” report authors stated.

Providing patients with better care and better outcomes at a lower cost relies heavily on the IT infrastructure healthcare organizations use to provide clinicians with the tools they need to achieve this goal.

The report outlined several groups and their respective goals around value-based care, including provider prospective and patient prospective.

From a provider perspective, significant gaps remain in what providers want to do and what their infrastructure technology allows them to do.

Lack of a standard API limits clinician access to external data and advanced analytics that give the clinician a full view of a patient’s health.

APIs are necessary for the future of health IT so clinicians can gain access to a full spectrum of patient data. This interoperability is crucial, but there is currently no API standard, meaning that clinicians cannot access certain information using current health IT infrastructure tools.

Federal policy makers are developing API standards and are ensuring that APIs are standards-based and published in the public domain. Certified APIs also need to include a core set of data elements to be profiled by groups that capture clinical data in practice and use the data in research and clinical decision support, report authors advised. These APIs must also be extended over time through a community-endorsement process.

From a patient perspective, a new framework is needed to connect patients with their providers in the modern world. More patient devices are constantly communicating data and health IT infrastructure needs to support patient devices.

Not only do patient devices need to connect to the network, they also need to be equipped with HIPAA-compliant apps to ensure the data is protected at the endpoint and in transit.

“A burgeoning sector of technology applications routinely handle patient data without being considered covered entities or business associates, and that such non-covered entities (NCEs) may collect, share, or use health information about individuals in ways that may put such data at risk of being shared improperly,” the report stated.

The report suggested that organizations consider the future of patient wearables exchanging information with EHRs, but advised that the technology is still young and accuracy issues may arise.

Organizations are also ready to use HIT infrastructure technology and patient wearables to more readily engage patients in research opportunities and alert clinicians when certain patients may be relevant to a study. Alerts can be set up to identify when a patient’s EHR matches up with clinical research criteria.

Report authors suggested that the federal government should find ways to incentivize clinicians and healthcare systems to partner with researchers and adopt tools to better engage patients.

Health IT infrastructure is becoming more advanced, but there are still many digital gaps and hurdles organizations need to overcome to achieve true interoperability and functionality. As organizations continue to integrate new health IT systems over one another, their ability to work together and accept new technology has grown complicated.


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