ONC turns to medical community to boost interoperability

Benjamin S. Brooke, MD, PhD, heard from physicians across the professional spectrum that they weren’t getting or couldn’t easily access the information they needed to make decisions about their patients.

The information, he was told, was either buried in notes compiled within electronic health records (EHR) systems or locked away in the technology.

“We have a weakness in how we communicate information between providers,” he told Medical Economics.

Brooke, a vascular surgeon and director of the Utah Intervention Quality & Implementation Research at the University of Utah School of Medicine, is leading one effort to improve the flow of information between primary care physicians and specialists.

The University of Utah team created a dashboard that physicians can use with their EHRs to easily provide relevant patient information. Primary care physicians can use the application to select pertinent data to share with specialists as they refer patients for services, and specialists can do the same when sending patients back to their regular doctors for follow-up care.

This dashboard, which is built on the emerging open Sustainable Medical Applications and Reusable Technologies (SMART) on FHIR standard, ensures the right information gets to the right clinician at the right time – a key component of interoperability, Brooke said.

“This is a communication tool that could be used across different specialties and even across different health systems,” he added.

‘Key building blocks’ to improve information flow
The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) in September announced seven recipients of two cooperative agreement programs to improve the flow of health information. The awardees will share a total of $1.5 million to create standards-based solutions that facilitate the exchange of health information.

Next: Improving the patient and provider experience

“These programs will serve as key building blocks for improving the patient and provider experience with the flow of health information,” B. Vindell Washington, M.D., ONC’s  national coordinator said when announcing the names of the seven recipients, including the University of Utah.

The Health Collaborative, a Cincinnati-based nonprofit, is another awardee. ONC selected it for its work with the Strategic Health Information Exchange Collaborative (SHIEC) to use existing standards to advance a network of networks model for sharing patient information.

“It really puts the patient at the forefront and tries to break down some of the invisible barriers we have with state lines,” said Jason Buckner, senior vice president for informatics at The Health Collaborative.

The project, known as the Heartland Pilot, involves seven existing health information exchanges (HIE) – three in Indiana and one each in Kentucky, Michigan, Ohio and Tennessee.

Although patient information can flow between providers and healthcare institutions within any given HIE, that same patient information does not typically flow from one HIE to another.

This pilot seeks to change that, Buckner said, using existing technology standards to connect different HIEs so that doctors only need to know a patient’s name and address to query the network to receive the patient’s medical records from the patient’s home HIE.

“What we’re producing is a legal process and technical framework. We’re testing multiple different standards and processes to test out what works, and the work product would really be a framework to share data nationally,” Buckner said.