Achieving the promise of IT interoperability

Feb. 22, 2021

If ever there was a time when interoperable information systems were critical, the time is now during the COVID-19 pandemic.

Think about how various professionals in the healthcare system require timely access to critical pieces of information to both care for patients and monitor SARS-CoV-2’s activity in local communities and the world.

For example, testing respiratory samples for the virus involves information sharing. Laboratories need to know the demographic information for the patient associated with a specimen. If they are not going to test the sample themselves, they need to share the patient’s data with a reference lab. Once testing is complete, labs need to provide results to the patient and healthcare provider, report testing data to public health authorities, and bill an insurance company or government program.

Vaccinating patients is another example. Providers need to know the demographic and insurance information of the patients they vaccinate. They also need to know if patients have had a first dose of the vaccine, and if so, which one they have had. It also is important for providers to know if patients have had a reaction to a vaccine in the past or if their immune system is compromised.

Meanwhile, hospitals and emergency rooms need access to COVID-19 patients’ medical histories, drug allergies, current medications, and demographic information, including socioeconomic variables.

But the flow of information does not always happen as smoothly as it could. Phone calls, faxes and paper forms are often part of the process.

This was not the vision policymakers had in mind when they appropriated taxpayer money to fund the installation of electronic health records (EHRs) at hospitals and doctor’s offices throughout the country. This has happened through the Meaningful Use program, which is now called Promoting Interoperability. As of 2018, the Centers for Medicare & Medicaid Services (CMS) had paid more than $38 billion in incentive payments to reward hospitals and physician’s offices that logged measurable goals related to using and sharing electronic information to provide high-quality, cost-effective patient care.

Signed into law in 2016, the 21st Century Cures Act also included provisions to improve data sharing, based on the lessons learned from implementing the earlier regulations. CMS and the Office of the National Coordinator for Health Information Technology (ONC) released final regulations in 2020 to implement these provisions; although both governmental bodies extended deadlines because of the pandemic.

One aim of the regulations is to prohibit information blocking, which involves actions that impede access to patient information. A common example of this is when an information technology vendor with proprietary software charges an excessive fee to build an interface, linking its system to another system.

Labs managers are all too familiar with this phenomenon. I am sure most of them have felt frustrated at some point trying to move patient data from their laboratory information system (LIS) to an EHR at a hospital or doctor’s office.

As a result of the COVID-19 pandemic, we can see how important seamless information exchange is to the goals of providing high-quality patient care and managing public health crises. Hopefully, the regulations from the Cures Act will help propel the healthcare industry toward true interoperability.

On a separate note, Marisa Williams is Medical Laboratory Observer’s new Managing Editor. Earning her Master’s in Writing at Johns Hopkins University and Bachelor of Science at the University of Toledo, emphasizing Forensics, she is the author of more than 100 independent books.

I welcome your comments, questions, and opinions – please send them to me at [email protected]

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