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Progress toward interoperability is gaining momentum


Approval of first TEFCA applicants marks important milestone in drive for universal data-sharing

Earlier this month, the U.S. Department of Health and Human Services (HHS) announced it had approved the first set of applicant organizations for onboarding as a Qualified Health Information Network (QHIN) under the Trusted Exchange Framework and Common Agreement (TEFCA). TEFCA was established as part of the 2016 21st Century Cures Act with the goal of creating a “universal floor for interoperability” as well as the standardized infrastructure required for data to be shared effectively across the many types of organizations supporting health care.

The announcement of the first six approved QHIN applicants represents a significant step forward for interoperability in the U.S., and it couldn’t come at a better time.

More and more of the health care ecosystem is incorporating digital tools to diagnose, treat, monitor and communicate with patients, and all of those tools create growing quantities of data. That, in theory, is great news for everyone, because it means those who provide, receive, and pay for care can make more informed decisions. The reality, however, can be much different, largely because our health care system lacks the infrastructure and standards needed to seamlessly and efficiently access, exchange and use the available data.

Too much of the data created by new digital tools remains siloed, meaning it never makes it to the person who needs it to inform the next decision about a patient’s care, whether that be the patient themselves or their doctor. In fact, a recent report from our company on the state of interoperability found that nearly 70% of digital health executives say there are gaps in the data their organizations are retrieving.

The result, to this point, is that clinicians and patients are not benefitting from all the information available to make the best decision, resulting in inefficiencies, missed opportunities for preventive and emergency care and suboptimal outcomes. The issue is magnified by the ongoing shift to value-based care, which rewards quality care and outcomes, such as reduced readmissions, that are enabled by a clearer, more comprehensive view of the patient.

In more than 35 years as a practicing physician, I’ve seen how important holistic patient data can be when it’s easily available and integrated into the clinical workflow. But I also know the burden that recordkeeping puts on today’s clinicians and can detract from both the quantity and quality of time with patients. Spending 10 minutes locating, organizing and reviewing data for a patient may not seem like a lot on its own, but when it’s half of a 20-minute appointment, the negative impact on patient care becomes clear.

But the outlook is not all doom and gloom. The industry is headed in the right direction by taking steps toward ensuring more automated and seamless data interoperability in health care, although the changes brought on in part by TEFCA won’t happen overnight.

For one, we need to ensure the data being shared is quality data, i.e. not duplicative, incomplete or useless. Fewer than half of hospital CIOs surveyed in our report on the state of interoperability described the data from health information exchanges as “good” or “near perfect.”

Privacy is also a concern. As more data is shared, there are more opportunities for security breaches, resulting in additional strains on engineering teams, costs for the infrastructure and creation of liability issues.

Nevertheless, the path to interoperability is clear among nearly all participants. Decision makers recognize that interoperability needs to be a priority in 2023, with more than half of health system CIOs saying they plan to spend up to 20 percent more on interoperability in 2023 than they did in 2022, and 68 percent reporting that they’re actively working to comply with published TEFCA standards meant to enable improved interoperability.

There is also an encouraging sense of urgency for the organizations involved in getting the pieces of TEFCA up and running. All six of the approved QHIN applicants recently pledged to have their networks live by the end of 2023, meaning a better, more connected future for our health data is closer than it has ever been.

But getting to that future will require work. The implementation of TEFCA is ongoing, and its inherent reliance on collaboration and coordination across organizations and industry participants means it will be more complex than just flipping a switch. But as we work toward greater interoperability there will be clear benefits for patients, providers, public health and health care administrators. There’s no doubt that improved interoperability is a worthwhile undertaking.

Steven Lane is chief medical officer of Health Gorilla

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