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Feds outline plans for electronic exchange of patient information

U.S. has given out $5 billion in EHR incentive payments to 76,000 healthcare providers

May 3, 2012 02:37 PM ET

Computerworld - The U.S. government expects to provide both money and standards guidance to encourage healthcare providers to deploy and use health information exchanges (HIE) in a manner similar to the way electronic prescription technology was deployed and adopted.

During a webinar Wednesday, Claudia Williams, director of the State HIE Program at the U.S. Office of the National Coordinator (ONC) for Health Information Technology, said the public process to establish standards for HIEs will begin "very soon" after the comment period ends for Phase 2 rules for meaningful use of electronic health records (EHRs). That comment period ends May 7.

The ONC will first publish a request for information, followed by a notice of proposed rule-making and then a final rule.

Williams said the government does not intend to set up HIEs or restrict them to one type -- whether national, state, regional, public or private. The government's role will be to establish the vocabulary and the code sets to ensure information contained in electronic health record (EHR) systems can be exchanged no matter which network platform is used.

"A national health information network is a set of standards, services and policies that allow information to flow across the Internet in a safe and secure way. We also do not expect there will be one solution, or one architecture or a one-size-fits-all [approach]. We think multiple approaches will sit side by side," Williams said.

The government will use both grant incentives and penalties to encourage providers to exchange information in a certified way. Williams called the HIE program "voluntary" but with a validation process. Criteria will focus on data transport, querying, provider directories, privacy and security expectations, and business practices of every validated entity.

Williams said some state HIE grantees, like Texas, are offering vouchers to healthcare providers to purchase exchange services today.

HIEs will allow physicians to exchange patient treatment data, prescriptions and radiological images such as X-rays, with other medical facilities. Standardizing data transfer protocols will allow that information to be exchanged with non-affiliated facilities. For example, a specialist from a cancer treatment center could share test results with a patient's primary care physician in a different hospital network or different part of the country.

With regard to helping to build state-level HIEs, the ONC will focus on standards for electronic prescriptions, the exchange of patient care summaries, lab test results, public health statistics reporting, and overall patient engagement in healthcare.

Williams said the ONC recognizes that "every state is different, so there cannot be a cookie-cutter approach."

"You'll see a wide variety strategies ... depending on what's already in place in a state. We're focusing our efforts on the certification part of it. It's not that we want to be the builder. What we want to do is have the standards, the policy and the services that we're enabling through our regulations and through our standards work," she said. Williams explained that the government will also be consulting with the private sector to establish the "building block" needed to create cheap yet effective exchanges.

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