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 The rip-and-replace strategy is outdated, given the advanced data exchange capabilities that are out there.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.