HIEs Have Insufficient Standards, Numerous Obstacles

By Katie Wike, contributing writer

Government Accountability Office report lists privacy issues, insufficient standards, too many expenses as barriers to HIE

A report released by the Government Accountability Office recently found despite providers recognizing the value of health information exchanges (HIEs), specific hurdles are keeping them from implementing and using HIEs to their full potential.

According to iHealth Beat, providers in Georgia, Massachusetts, Minnesota, and North Carolina were interviewed for the report.

Health IT Security reports these providers cited four challenges to HIEs:

• Concerns about variation in states' privacy regulations
  The difference in state privacy regulations makes it difficult for providers to exchange records - especially when they operate near state lines. “Moreover, some states have different perspectives on obtaining patient consent, such as whether consent is required only initially or for each transaction, when exchanging patient data.”
• Costs related to HIEs
  Cost was another concern, with some providers estimating amounts from $50,000 to $80,000 to establish data exchange interfaces. ONC’s State Health Information Exchange Cooperative Agreement Program has provided funding to HIE organizations, however this program is slated to end this month.
• Difficulty matching patients with their records
  “Multiple providers and stakeholders cited situations in which several of their patients are listed with the same name and birth year, and live in the same area. Two of these providers reported that patients can be matched to the wrong set of records,” said GOA. This creates a need to manually match the records which quickly becomes time-consuming and expensive.
• Inadequate standards
  “While standards for electronically exchanging information within the EHR programs exist, providers reported that standards may not be sufficient in some areas,” states the report. “One area for which providers told us standards were insufficient relates to standards for allergies. Specifically, one provider noted that there are not sufficient standards to define allergic reactions, and another provider explained that some EHR systems classify an allergic reaction as a side effect, while other EHR systems classify the same reaction as an allergy,” explained GOA.

HealthIT Security further notes, “Though it didn’t criticize current work, GAO recommends that CMS and ONC:

1. Develop and prioritize specific actions that HHS will take consistent with the principles in HHS’s strategy to advance health information exchange.
2. Develop milestones with time frames for the actions to better gauge progress toward advancing exchange, with appropriate adjustments over time. In commenting on the draft report, HHS, including CMS and ONC, concurred with these recommendations.”