Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the third in a three-part series that will address aspects of interoperability: 1) overcoming barriers 2) financial motivation and standards, and 3) information blocking.

An important consideration for information liquidity are the physician practices (small and large) and independent hospitals that have been pressured to move off of their current Electronic Health Record (EHR) system – Allscripts in some cases – to one used by the large enterprise health system in their area.

It’s called “data bullying” or “information blocking,” because one party isn’t committed to establishing connectivity between current systems and in some instances, will even put up indirect roadblocks. For example, sometimes larger health systems compel change through conversations about referrals and threats not to include people in data networks.

With today’s technology, it isn’t necessary to change EHR systems to provide physicians and other medical professionals with access to the information they need. The rip-and-replace strategy is outdated, given the advanced data exchange capabilities that are out there.

The Allscripts dbMotionTM Solution, our interoperability platform, provides an advanced semantic engine that aggregates and normalizes all clinical content across a connected community into a single view. It’s accessible within whichever EHR the provider uses, to enable them to find relevant information quickly while with the patient. This technology is in use across numerous communities in the U.S. and overseas, including the entire country of Israel, and in each environment, it’s connecting dozens of different vendors successfully and directly changing the care decisions being made because of the additional information that’s available.

The ONC report on information blocking stated that it occurs when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. But the report also notes that the extent to which such information blocking is impeding the effective sharing of electronic health information is not clear because much of the evidence is anecdotal and difficult to interpret.

An additional factor at play is the commoditization of data. Health care is mirroring a trend seen virtually everywhere in business – attempts to access and/or control data are driving many of the dynamics that are being discussed today. “Big data,” population health, personalized medicine, quality-driven reimbursement and information exchange – each a conversation about data and its enormous potential. Until there is greater clarity regarding the so-called “ownership” of the data, this ambiguity will continue to be a significant factor in negotiations around interoperability.

I believe the Health IT industry has a real responsibility to advance interoperability, along with the provider organizations that we support, and I feel strongly that this is doable. I challenge all of my colleagues to continue working together with us, the provider stakeholders, the ONC and the patient community until we have achieved success.

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About the author

Paul Black currently serves as board member and chief executive officer of Allscripts. As CEO, Paul guides company direction to fulfill its global commitment to build Open, connected communities of health. Prior to joining Allscripts in 2012, Paul spent more than 13 years with Cerner Corporation in various executive positions, retiring as Cerner’s chief operating officer in 2007. During his tenure with Cerner, he helped build the company into a market leader in healthcare information technology with more than $1.5 billion in annual revenue. Paul also spent 12 years with IBM Corporation in a variety of leadership positions in sales, product marketing and professional services. Paul has served on several private company and nonprofit boards of directors for companies in healthcare information technology, healthcare services and consumer Internet marketing. He is currently immediate past chairman and an officer of Truman Medical Centers, a 400-bed safety net academic hospital in Kansas City, Mo. Paul holds a Bachelor of Science degree from Iowa State University and a Master of Business Administration from the University of Iowa.

2 COMMENTS on Achieving the promise of health IT: Stop information blocking and data bullying

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John Parker says:

07/31/2015 at 3:08 pm

Mr. Black–I appreciate your comments on the need for interoperability among EHR’s and the steps that need to be taken to get us where we need to be. However, as outline in the editorial in the summer edition of The Pharos, entitiled The Tragedy of the Electronic Health Record–

(http://www.alphaomegaalpha.org/latest_issue.html),

the problems with EHR’s go beyond just the lack of interoperability. What is Allscripts doing to address these other problems?

Paul Black says:

08/04/2015 at 9:20 am

Hi, John –

Thanks for your comments. It’s our job to make sure our clients have the best technology available to deliver the best patient care possible. Health IT has made great progress with EHRs over the past several decades, but we can always do better.

Allscripts works closely with our clients when developing solutions. In addition to the need to advance interoperability – what this blog series has been all about – I’ll also briefly address some of the recommendations noted in the article:

– Simplify documentation – Today’s regulatory environment requires significantly more documentation than ever before. It would be nearly impossible to keep up with a paper-based record system. As these regulatory demands increase, we work hand-in-hand with clients to streamline this process as much as possible. It’s also important to note that our system is designed to be flexible, so organizations can design workflows – documentation and beyond – that work best for their clinicians.

– Open platforms – The article points to closed systems as part of the problem, and I couldn’t agree more. Allscripts has an Open platform for our solutions, and makes our APIs available to developers to speed innovation and quickly incorporate the technology our clients need most. Our commitment to working with others across the industry is also reflected in our involvement with the CommonWell Health Alliance.

– User-centered design – Our solutions are designed by clinicians, for clinicians. Our user-centered design team extensively researches and tests solutions with clinicians in the field to make sure we’re delivering technology that meets their needs.

Our clients have incredibly important work to do, and we remain focused on supporting them with high-quality Health IT solutions – and we remain committed to continuous improvement.

Best regards,
Paul

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