The electronic health record (EHR) system was envisioned to be a patient-centric modality to increase access to patient health information across concrete boundaries in a secure manner. It increased the conscientious patient’s access to personal health information through secure patient portals. It enabled providers to have remote access to patient data. Despite the technological revolution, it has left providers and patients equally dissatisfied. Patients now share their face time with providers with a documentation screen. Providers are caught in a cloud-based web between EHR documentation, electronic pre-certifications, prescription faxes and endless static across telephone lines with automated callers.
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law Feb. 17, 2009. The technology revolution in patient health information has also brought the formidable challenges of data security, transfer and ownership.
Healthcare is at a very interesting juncture that we are calling “mining is the new medicine.” A medical mining consult for a patient is in the foreseeable future. This is given the conglomeration of all patient data points and its interpretation, which requires the recognition of infinite patterns. The pattern recognitions then require further interpretation in the context of current guidelines and risk-to-benefit ratios. The operational success with medical mining rests in the ability to sift through all relevant patient data, which might be at the current time securely resting across multiple healthcare systems and non-affiliated Institutions as individual data silos.
History of EHR interoperability
The 2015 Edition Health IT Certification for EHR technology must be met under the MACRA proposed rule. JASON, founded in 1960 provides independent consulting services to the U. S. government on defense science and technology. It is a scientific advisory group that made recommendations to embark on Stage 3 of Meaningful Use, focused on a functional interoperable EHR system.
The JASON report was requested by HHS through the Office of the National Coordinator for Health Information Technology (ONC) and Agency for Healthcare Research and Quality (AHRQ). The JASON Briefings, reviewed the shortcomings with two of the world’s largest EHR systems, the Veterans Administration Vista and the DOD system using the Armed Forces Health Longitudinal Technology Application (AHLTA). Several private commercial EHR systems have also thrived in the past decade. The JASON study process involved an expert panel from the academic, industry and government sectors. In addition to the interoperability, it has identified setbacks in the health infrastructure. JASON has emphasized the importance of standardization and data security between the shared data systems and data ownership.
JASON briefings have several recommendations, including unbiased third-party certifications through organized “code-a-thons.”
The buzzword in health IT is “interoperability.” We have progressed from an era of EHR implementation and adoption to open data exchange between providers in healthcare and patients. Despite the initial dissatisfaction between the patients and the providers with shared screen time, there is an impetus to unify the EHR systems across systems and make the patient in charge of sharing relevant health data to the providers. The current DOD electronic medical records system, the AHLTA and the VA Vista system, were built on a common foundation of the modules-based MUMPS engine. The two systems had several failed attempts at achieving interoperability. In 2013, Secretary Chuck Hagel, pledged to adopt a commercial solution that would allow the DOD to exchange meaningful secure data with the VA Vista system.