- A mixture of technical, regulatory, and behavioral barriers will continue to hamper health data exchange efforts within the Department of Health & Human Services through 2017, according to the Office of Inspector General.
This week, the federal agency published its list of the top management and performance challenges that its parent agency is currently facing. Among them is health IT and its role in exchanging and using electronic health data.
“Health IT, including electronic health records (EHRs), offers opportunities for improved patient care, more efficient practice management, and improved overall public health. However, HHS continues to face a number of significant challenges in this information-rich environment,” writes OIG.
Germane to the concept of healthcare interoperability are the barriers in robust information sharing between providers and other stakeholders, including the federal government:
To capitalize on growing amounts of data in the health care context, there must be meaningful access, subject to appropriate privacy and security safeguards, to complete, accurate, and timely data, where and when needed. However, enabling and encouraging the flow of information remains a challenge for HHS. Several factors may impede the flow of information. These include technical barriers (e.g., lack of interoperability), the complex nature of Federal and State privacy and security laws, financial considerations (e.g., the cost of health IT acquisition), and behavioral issues—such as information blocking and consumer confidence—that relate to a willingness to share information.
As OIG notes in the report, the inefficient exchange of health data has serious implications for patient safety as well as federal-level initiatives to promote innovations in healthcare delivery (e.g., precision medicine, genomics).
Internally, HHS faces risks associated with limited health data exchange that could negatively affect provider reimbursement and quality improvement.
“For example, data created, maintained, or transmitted using EHRs or other health IT are used to ensure correct Medicare and Medicaid payments, including value-based payments,” OIG explains. “Participants in certain initiatives also receive Departmental data for their use in improving the care they furnish. Additionally, HHS increasingly uses and shares data as part of its program operations and program integrity efforts.”
In order to derive value from provider data, HHS must remove impediments preventing data aggregation and in turn analytics. Additionally, poor health data exchange could compromise data integrity use to assess the various programs the federal agency oversees.
Citing prior work, OIG has pointed to concerns already raises about the completeness and accuracy of data currently residing in HHS information systems.
In the report, OIG lays out the activities HHS must follow through on in order to improve health data exchange:
To reach HHS's goals … HHS must do more to improve the flow of complete, accurate, and timely information, subject to appropriate privacy and security safeguards. This includes ensuring that HHS's data systems are developed and operated in a way that delivers complete, accurate, and timely data. HHS must also find ways to remove potential barriers to leveraging health IT and related data to advance public health initiatives and to facilitate sharing and use of information along the entire continuum of care (beyond just those who are eligible for EHR incentives).
OIG also notes that health IT interoperability barriers will challenge providers in the Quality Payment Program who will require technical assistance and additional guidance from HHS to remove.
Future OIG investigations will focus on the ability of HHS to make progress addressing the key components of health IT and its role in exchanging and using electronic health data.