Four health information organizations recently convened to discuss their challenges and successes in interoperability stability and infrastructure.
A health information organization is government-led, nonprofit group that creates interoperability and EHR exchanges on a state, regional and national level. They usually are helmed by a board of leaders from different sectors of healthcare.
These organizations were awarded $2.5 million in 2016 from the Office of the National Coordinator for Health Information Technology (ONC) to advance admission, discharge, and transfer (ADT) notifications to providers, facilities, and care managers within their states and to neighboring states.
Here are four of the biggest challenges they encountered, based on findings released in an ONC whitepaper:
1. Rules restricting information sharing
The Delaware Health Information Network is an HIO that aimed to grow its ADT notifications with providers, hospitals, and consumers within Delaware. It ran into challenges communicating with other health information organizations that had more restrictive agreements limiting the type of data being shared and the types of providers, hospitals, and patients allowed to receive the data.
For example, one HIO required patients and providers to have had a face-to-face encounter in the last 18 months in order for the patient’s data to be sent to the provider. In response to this issue, DHIN built new technology to proactively ask providers in Delaware their National Provider Identifier numbers to verify patient-provider relationships.
2. Behavioral health disconnects
Reliance eHealth Collaborative, an HIO, and the Oregon Health Authority had three goals
- Expand ADT notifications with high-risk patients in Oregon;
- Collaborate with the Emergency Department Information Exchange and PreManage to connect with hospitals in Oregon, Washington, and California; and
- Allow providers in Washington and Northern California access to Oregon Health Authority’s statewide Flat-File Directory.
The collaborative reported difficulties creating robust alerts that reported on clinical concepts and not just a single health event. The organization also faced barriers connecting with behavioral health EHRs. “Reliance reported that it might have been able to alleviate some of the challenges of working with behavioral health EHRs had it started working with these vendors earlier in the program,” according to the ONC report.