The potential for wide-scale data sharing across healthcare is gaining in equal parts reality and complexity, panelists at Redwood MedNet’s conference said last week in California. Despite some significant challenges that need to be overcome, the consensus was that the health data revolution will arrive sooner than later.
Keynote speaker John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston, identified two of the biggest barriers: conflicting state laws and multiple health information exchanges in each state.
“We’re always going to have multiple health information exchanges,” he said. “HIEs are not a one-size-fits all.”
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He also said state policies need to be adaptive, so as to permit the flow of data that will enable informed population health.
“As a policy matter, let us hope that as we build these technologies, our state governments allow such issues as to send data to a public health registry, school nurses, etc.” Patients who are uncomfortable with sharing too much can be given a chance to opt out, but such privacy concerns shouldn’t prevent the basic concept of data sharing or make it illegal or overly difficult, he said.
Perhaps just as important, patients need to be empowered with their own data.
“Patients can download their data, but they often don’t because there’s not much they can do with it,” he said. “It’s all about getting data from the patients. This is going to be more and more commonplace – shared care plans, and hopefully sharing them across EHRs through an HIE.”
The healthcare IT sector needs to be ready to handle even more data than HIEs are currently generating, said John Mattison, chief medical information officer for Kaiser Permanente’s Southern California Division.
“There’s an avalanche of data available already,” he said, noting that providers and payers should assume 10 times that amount will be available in just five years.
“We can’t possibly manage the data we have today. We have to develop much more sophisticated filters and sensors to escalate the info to humans,” he said.
Mattison was the most optimistic about the near-term potential of HIEs.
“We are at the cusp of seeing the fulfillment,” he said. “Things are going to change very, very rapidly.”
Paul Biondich, a researcher at the Regenstrief Institute and co-founder of Open Medical Record System, said that while there is reason for optimism, some basic infrastructure is still needed for any national effort.
“Technology is the easy part,” he said. “One of the things we’re trying to do with an HIE is create better communities. What we’re trying to do is come up with basic operations, not customized APIs.”
Dean Sittig, professor as the School of Biomedical Informatics at the University of Texas in Houston, offered a more sober analysis, noting that there is still a ways to go, but that HIT would eventually get there. He said there’s “a key unaddressed grand challenge in clinical information that requires multiple, organizational aggregate data.” The data collection is not quite there yet, he said.
There also was a panel discussion on California’s interoperability challenges, with officials from the California Association of Health Information Exchanges detailing efforts and challenges facing the massive landscape just within the state.
Robert Cothren, executive director of the association, made the case for a regional exchange that melds components of some 30-odd HIEs in California and other western states, but noted that it would be difficult.
A “framework that allows unaffiliated organizations to trust each other for the purpose of exchanging health information” needs to be established and it needs to be able to scale across multiple states and the nation. Whatever is developed in the near future needs to “reduce the cost of data sharing,” he added.
More information on the conference and presenters can be found here.
