Image source: UC Berkeley
Hospitals produced an estimated 697 million megabytes of data in 2015. That’s more than two megabytes of medical data for every man, woman and child in the United States. And while we may spend billions of dollars and more hours entering data than seeing patients, much of that data remains inaccessible, hidden behind proprietary data architectures, authorizations and patient matching problems.
Physicians and patients have begun to demand more even as health information exchange (HIE) slowly becomes mainstream. Physicians, patients, payers and regulators are all seeking more access to data. Soon electronic health records will be joining the HIE movement.
Since 2010, non-federal acute care hospitals have rapidly increased their health information exchange capabilities. Today, 76% of such hospitals electronically exchanged laboratory results, radiology images, clinical care summaries or medication lists with outside ambulatory care providers or other hospitals. Wider HIE still faces barriers from hospitals competing with each other to protect market share and cross-vendor EHR interoperability.
For those outside of the health IT sector, including most physicians and patients, it can come as a surprise that health information exchange efforts have operated largely outside of electronic health records. National, state and private market solutions have all sprung up alongside ever increasing EHR adoption (see a brief overview of Verizon’s ongoing efforts here). In fact, the national eHealth Exchange now reaches 40% of hospitals nationwide, four federal agencies, more than 13,000 medical groups, 3,400 dialysis centers, and 8,300 pharmacies.
Providers will likely be demanding their EHRs fit into such projects. The value proposition for EHR adoption was obvious: keep up with the market, capture bonuses or start to be penalized. The value proposition for HIE has always been a little more opaque. Physicians and hospitals have little incentive to demand interoperable, plug and play, data exchange. Meaningful use criteria did not require exchanging information among providers. Competing, local health care providers often did not want to invest in creating a fledgling system to share patient data.
Now, Stage 2 Meaningful Use criteria include HIE requirements. In particular, for greater than 10% of transfers a “provider of care must provide a summary of care record electronically.” The private market, thanks in part to regulators, may be about to demand wider HIE.
And it’s about time. And efficiency. Eliminating redundant tests could save more than $8 billion dollars per year nationally. Recently, a pilot project sponsored by the Brookings Institute and HEALTHeLINK, an HIE collaboration in Western New York, demonstrated a 25-50% reduction in laboratory tests and radiology exams among emergency room patients. Not to mention wait times and radiation doses are decreased too.
Healthcare IT has run into problems when it creates more administrative and data entry headaches than it solves. Reliable, widespread, convenient healthcare information exchange will hopefully make all of those growing pains worthwhile. If we can access them, those 697 million megabytes of data may just improve care while saving time and money.