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Q&A: CHIME's Sharon Canner
Sharon Canner has a unique and practical purview into how the Nationwide Health Information Networkis progressing. As the senior director for advocacy programs, she leads the government affairs function at the College of Healthcare Information Management Executives (CHIME), overseeing CHIME's CIO StateNet and its Policy Steering Committee.
Government Health IT Editor Tom Sullivan interviewed Canner about the obstacles along the road to a grand NwHIN vision, uncharted future funding for the HIEs and RHIOs that serve as the foundation to NwHIN, and what it will take to make nationwide health data exchange a reality.
Q: RHIOs and HIEs are emerging largely isolated from other RHIOs and HIEs, save a few examples. … Is this inhibiting or slowing the growth of NwHIN?
A: Many simultaneous forces in play have implications for health information exchange, some of which are occurring outside local and/or state-based RHIOs and HIEs, which could potentially connect with the Nationwide Health Information Network. For example, the Care Connectivity Consortium members – Geisinger Health System, Kaiser Permanente, Mayo Clinic, Intermountain Healthcare and Group Health Cooperative – have joined together to securely exchange electronic health data. Development of standards, protocols and best practices will continue to evolve in this dynamic health IT environment. Having pockets of HIEs emerge from various stakeholders in different parts of the country does not necessarily inhibit NwHIN, but depending on what practices emerge from these, NwHIN may look slightly different than originally envisioned.
Q: There is some regional and statewide health information being exchanged, but what will it take to for that to really happen on a nationwide level?
A: To meet the immediate needs of providers, ONC launched the Direct Project in March 2010 to facilitate one-way communication between providers. Likewise, HHS is supporting the open source (Aurion) platform that allows organizations to exchange health information using recognized interoperability standards. But for these projects to morph into NwHIN, ONC and HHS must focus more policy and resource levers to incent development, agreement and adoption of national standards. With so many pieces evolving, coordination and attention to the primary objective of NwHIN – exchange of data for better patient care – must be kept at the forefront.
Q: The BronxRHIO and Maine's HealthInfoNet, among others, are uncertain where future funds will come from. If these centers don't succeed, what becomes of the NwHIN model?
A: Sustainability has long been a major hurdle for health information exchange. State plans should include provisions for ongoing sustainability, ensuring funding is applied equitably. For example, MedAllies (Hudson Valley, N.Y.) is a unique health information service provider specializing in EHR implementation in addition to providing the infrastructure to enable the secure sharing of medical information among providers. Since 2001, MedAllies has successfully managed the Hudson Valley Health Information Exchange, which connects multiple hospitals and labs to a common technology platform used by over 500 physicians to manage over 250,000 patients. In addition to governance and technical standards currently being tested across the states, funding strategies can be expected to emerge. HHS and ONC will likely do more in the way of identifying and evaluating financial models and piloting promising new structures.