Health and Science

New pact to make electronic health records 'work better'

New pact to make electronic health records 'work better'
New pact to make electronic health records 'work better'

Is getting your health records finally about to become as easy as booking an Uber?

The Obama administration on Monday night announced a new agreement with major hospital systems and leading electronic health record vendors to make it easier for patients to access those digital records, reduce barriers to sharing the information between health providers, and standardize technology that would better allow communication across the platforms containing patient data.

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The agreement involves vendors that provide 90 percent of the electronic health records (EHRs) to U.S. hospitals, as well as health-care systems in 46 states, including the nation's five biggest private health systems.

More than a dozen professional health organizations also have signed on to the agreement, the latest step in the transition from a system that once relied on paper to document a patient's medical history to one that relies on electronic bytes for that task.

The pact, which has three main commitments, represents an effort by the Obama administration to speed up an ongoing effort to make digitized records more effective in helping treat patients and improve portability of the electronic data.

Despite that effort to date, EHRs are not always readily accessible, not always usable in the form that providers receive them and not always easy for the patient to understand, said Dr. Karen DeSalvo, national coordinator for health information technology at the U.S. Health and Human Services Department.

DeSalvo said the pact "reflects a shift in the way that [EHR] developers and providers are willing to do business."

Under the agreement, the participants commit to help patients "easily and securely access their electronic health information, direct it to a desired location, learn how the data can be shared and used, and be assured the data is being effectively and safely used," according to a fact sheet distributed by HHS.

Another commitment is to not "block" information, allowing health providers to share patient records with other providers and the patients themselves, and not unreasonably interfere with such sharing.

The third commitment is to implement federally recognized, national interoperability standards, policies and practices for EHRs.

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"These commitments are a major step forward in our efforts to support a health-care system that is better, smarter and results in healthier people," said U.S. Health and Human Services Secretary Sylvia Burwell.

She revealed the agreement during a speech Monday at the Healthcare Information and Management Systems Society's conference in Las Vegas.

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In prepared remarks, Burwell said that "we have made tremendous progress to bring health care into the 21st century," noting that in the past six years there has been a dramatic increase in the adoption of electronic health records, with about 75 percent of all doctors now using them, along with almost every hospital in the country.

"But we still have work to do to get the real value of this information for providers and consumers," Burwell said. "As we look at where our current way of doing things falls short, it's in three areas."

Referring to those areas, Burwell said that "consumer access remains a challenge."

"It's great to have an electronic record, but if that record can't be easily accessed by doctors and patients because of clunky technology, then we aren't consistently seeing the benefit," she said.

Burwell also said that digital patient records are "still too often knowingly or unreasonably blocked" by hospitals or doctors, either because of business practices "or misunderstanding" of the federal health information privacy law.

And, she added, "Without agreement on a common data 'alphabet,' our technology is stuck speaking different languages."

Mary Paul, vice president in the information services division of Ascension, one of the participants in the agreement, said that "interoperability" is "core to the goal" of having providers connect with each other to care for their patients. (Ascension is the largest nonprofit health system in the U.S. and the world's largest Catholic health system.

Paul said the development of EHRs has been "a significant journey to go from a process where you collect information in paper form from many different sources."

But she noted that even with the rise of EHRs, "there are a lot of interests to coordinate ... a lot of different parties that really require come coordination."

"I think when the community of providers and suppliers come together to promote the same set of standards, I do think that will make change," Paul said. "What we're trying to do is speak with a single voice, and I do think that's important."

Another participant in the agreement is EHR vendor Athenahealth. The company's director of government and regulatory affairs, Stephanie Zaremba, gave a lukewarm assessment of how significant the agreement is, at this point.

"Signing this pledge must not be regarded as a significant accomplishment or milestone for any stakeholder," Zaremba said.

"Athenahealth is and always has been committed to the goal of achieving the same ubiquitous information exchange that is commonplace in every other sector of the information economy," Zaremba said. "We have signed the latest government-orchestrated 'private sector commitment to interoperability' and are once again on the record supporting the broad goals of achieving connected care."

"The problem, however, is that one would be hard-pressed to find a stakeholder in our industry that is not already rhetorically committed to those goals," she said. "We are at the point as an industry where we need more action and fewer words. We want to see the [Office of the National Coordinator for Health Information Technology] take a step back and allow the private sector to continue its progress around a 'bottom up' approach to interoperability, not a top-down approach centered around the low bar of federally recognized standards."

Premier, a health-care performance improvement alliance of 3,600 hospitals and 120,000 other medical providers, is another participant in the agreement.

Blair Childs, senior vice president and spokesman at Premier, said, "Members of the Premier health-care alliance are pleased to join other stakeholders that have pledged to voluntarily implement interoperability and public access standards in health information technology."

But he also said that, "While the pledge is a positive statement of commitment, we continue to believe that legislation is important."

Childs added, "We support a public rating system of vendors' technology based on its performance on outcomes measures of usability, functionality and interoperability. We also support the granting authority to investigate and fine vendors who engage in information blocking."