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3 truths of health data exchange

July 10, 2012 | Andrew Fitzpatrick, CEO of WPC

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In healthcare, the government mandates data structure for certain types of electronic exchange. Despite overwhelming evidence to the contrary, a mentality persists that standardizing and sharing data entails a difficult process to implement. People are often misguided and intimidated by the perceived complexities of structured data along with the technical obstacles of securely exchanging it with other healthcare entities.

Moreover, prior to more recent legislation, there has been little apparent economic incentive to focus on widespread interoperability unless these entities, largely represented by providers and insurers, agree to collaborate and define a clear strategy to achieve productive data exchange. With the introduction of the Nationwide Health Information Network (NwHIN), followed by the Direct Project and CONNECT software, there is hope that important technical obstacles to expanding the secure exchange of health information have been overcome, making it available to all that can benefit by its use.

[Related: ONC to stand up NwHIN-Exchange as non-profit HIE in October.]

Electronic Data Interchange (EDI) has successfully grown and perpetuated standardization across other industries outside of healthcare. Those industries realize structured data exchange makes sense in providing value to their core business and in gaining a competitive edge, though the source of competition is not based on owning the data. It can make good clinical and financial sense for healthcare, too.

There are three truths of health data exchange:

First, standardizing health data, through ASC X12 5010, ICD-10, Meaningful Use and the like, is the building block for transforming the U.S. healthcare system for the better. It drives innovation and unprecedented change. By handling the transfer of data more efficiently, we can reduce the costs of care and increase our efficiencies. Initiatives such as NwHIN and the Agency for Health Research and Quality’s United States Health Information Knowledgebase (USHIK) further these mandates that provide the means to exchange health data seamlessly.

Second, though healthcare EDI is built around a structured data model, emerging technologies and new ideas are redefining the perimeters of seamless exchange without the traditional structured format while ensuring integrity of the data. In the long run, an industry model with standardized metadata pays off in abundance.We can measure clinical results retrospectively, cross reference to more easily calculate the costs to achieve better outcomes, pinpoint the right care procedure, empower patients to be better stewards of their care and so much more.

[Q&A: Moving from PCMH to a 'medical neighborhood' via Direct.]

To cite an overarching conclusion in the President’s Council of Advisors on Science and Technology (PCAST) report dated December 2010 to President Obama, there are many advantages of focusing efforts on a universal exchange language that could create a robust ecosystem with “intrinsically extensible” semantics to drive the efficient exchange of health data.

Third, there is a cost to achieve this industry-wide initiative – which likely includes increasing the level of standardization and reducing the number of stakeholders implicitly incented to make exchanging healthcare data seem more difficult than it actually is. Again, NwHIN serves as an example of setting a precedent of how the industry can overcome these challenges. Making this vision a reality yields a fertile environment, ripe with opportunity for technically gifted, forward-thinking organizations.

Andrew Fitzpatrick is CEO of WPC (Washington Publishing Company). This article originally appeared on NHINWatch.

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Reader Comments (2)Login to Post a Comment

loeblas says: 3 truths
July 10, 2012 | 11:45AM GMT
jimkretz can you elaborate on why you say the data is not good for purposes mentioned in your item #1?
jimkretz says: 3 truths
July 10, 2012 | 10:46AM GMT
1. Standardizing around a billing format, X12 5010, does NOT accomplish much for EHR interoperability. Indeed using claims data is not very useful for either clinical data exchange or comparative effectiveness research.
2. EDI has been immensely useful in various industries but that has been true only after common data standards have been adopted. While SNOMED, LOINC, and RxNorm are called for in the meaningful use requirements, they have yet to be adopted widely by legacy systems publishers. Indeed, while MU 1 criteria requires the ability to exchange a modified form of the continuity of care document, HITSP C32, almost none of the currently certified software actually interpret those requirements with sufficient fidelity to the standard to actually exchange data. Work on defining, let alone adoption, of the consolidated continuity of care record is ongoing and not ready for prime time.
3. With luck NwHIN standardizes the transfer protocols but does not accomplish anything for the standardization of the data, clinical content. Overall, the piece is a little short on truths.

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