INDUSTRY TECH OUTLOOK19and interoperability requirements for these systems necessitate that information must be shared primarily with other healthcare provider organizations. The requirements do not extend to ensuring clinical researchers and the federal government can get data from the EHRs.· Lab Information Systems (LIS). Every commercial lab and most healthcare provider organizations have their own instance of a LIS. There are not requirements to share information between LIS systems, and the architecture of the data is not fully standardized to allow them to interoperate. Also, this data is limited in scope and includes demographics, lab orders, and results. It often omits symptoms, underlying health conditions, and more.· Local and state surveillance systems. These tools do not have a standardized data architecture across geographic borders. Data, therefore, cannot be fully and easily shared between states, with the federal government, or with researchers. Also, this data is limited in scope and predominantly includes demographics, confirmed diagnoses, and immunizations.· Health Information Exchanges (HIEs). Most healthcare providers organizations participate in health information exchanges. Theoretically, much of the important data to assess COVID-19 is passed through an HIE, but there are limitations here too. Often HIEs are state-based so that data with which they interact is geographically limited. National HIEs help to overcome this barrier, but participation in any HIE, let alone a national HIE, is not consistently in place for all healthcare providers. This leaves data again unable to be meaningfully shared within the health care industry or with government.The WorkaroundsWith data locked in thousands of silos, the entire industry is forced to use workarounds. On March 29, 2020, the federal government requested that hospitals report COVID-19 testing data to the U.S. Department of Health and Human Services (HHS) directly by emailing spreadsheets. Privacy and security concerns with this approach are material, so on April 2, 2020, HHS relaxed the rules regarding data sharing with public health authorities in order to obtain more of this data from frontline healthcare providers. Even when hospitals comply with this request, data has to be compiled once by the provide organization, emails, and compiled again by HHS. Statistics and insights are at least a day old, if not older. With hundreds of new cases a day, 48 or 72 hours worth of information is critically necessary.As another work around, some IT system vendors and other partners in health care and academia are now attempting to help consolidate data and more robustly analyze it. On March 23, the COVID-19 Healthcare Coalition, a collaborative with a goal in part to aggregate de-identified data to gain clinical insights and inform resource planning was formed. It includes well know technology companies as members including Amazon Web Services (AWS), athenahealth, CommonWell Health Alliance, Epic, Microsoft, and Salesforce. Cerner announced March 24 that it is working with the federal government to inform a national COVID-19 surveillance network and share relevant data elements with the consent of their customers.If these IT vendors, academic partners, and government agencies can come together to use data to meaningfully inform policy and health care delivery decisions is yet to be seen. Data aggregation, normalization, and analysis on the overall population will undoubtedly be very challenging.What Next?If the needed data on patients with confirmed or suspected COVID-19 and other communicable diseases was required to be interoperable and shared among healthcare provider organizations and state and federal governments, these workarounds would not be necessary.Meaningful interoperability of key data would allow for a quicker and more comprehensive response to disease outbreaks, saving money and lives.Providers on the front line of care delivery would be able to quickly assess a patient's risk and comorbidities. Meaningful interoperability would alleviate additional administrative work for hospitals. Researchers could more quickly and with larger sample sizes assess risk, treatment effectiveness, early onset symptoms, and more. Policy health agencies would have near real time monitoring and tracking of COVID-19 rates of infection and mortality under a model that could be used with other communicable diseases going forward. Meaningful interoperability of key data would allow for a quicker and more comprehensive response to disease outbreaks, saving money and lives.The Federal government and HHS can and must work with Health IT vendors and healthcare provider organizations to address this issue. Because of the structural problems present with data and interoperability within the health care system, we continue to wait for solutions at great expense to our country.
< Page 9 | Page 11 >