Saturday, June 13, 2009

Electronic Health Records (EHR) - Interoperability of Disparate Systems

As suggested in the figure below, there are technical, semantic, organizational, political and economic matters to consider when deciding how to move data and/or exert operations from one place to another. These challenges are present in the recently reinvigorated campaign to adopt and exchange electronic health records.

On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act (ARRA). The health IT component of the Bill is the HITECH Act, which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records (EHR) and establish health information exchange networks at a regional level, all while ensuring that the systems deployed protect and safeguard the critical patient data at the core of the system.

There are two portions of the HITECH Act -- one providing $2 billion immediately to the Department of Health & Human Services (HHS) and its sub-agency, the Office of the National Coordinator for Health IT (ONC), and directs creation of standards and policy committees; a second that allocates $36 billion that will be paid to healthcare providers who demonstrate use of Electronic Health Records.

The government is focused on two primary goals in this legislation: moving physicians who have been slow to adopt Electronic Health Records to a computerized environment, and ensuring that patient data no longer sits in silos within individual provider organizations but instead is actively and securely exchanged between healthcare professionals. Therefore, the vast majority of the funds within the HITECH Act are assigned to payments that will reward physicians and hospitals for effectively using a robust, connected EHR system.

In short, a great deal of largely-Government-funded IT work is about to be undertaken to enable often-disparate healthcare recordkeeping systems to interoperate. In the next few posts, I will address a number of the issues that need to be considered when planning such projects.