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HIMSS Review: Technology Priorities and Realities

Scott Mace, for HealthLeaders Media, March 12, 2013

Security and identity

During Q&A, a doctor from a large practice in New York City strode to the microphone to warn about the litigious atmosphere that HIE may enable. Attorneys able to openly access electronic medical records will have a field day with that longitudinal patient data, he warned, accelerating the pace of malpractice suits in the U.S.

Mostashari ranged from smiling to brow-furrowing in answering this issue. "The patient owns the data!" he exhorted at one point, stepping away from the microphone to plead his case. More soberly, he characterized the legal worries as "problems we didn't imagine happening before."

Meanwhile, away from the microphones, ONC's health IT policy committee labored in January to assure that patient consent travels with that data from provider to provider. Toward that end, ONC has tested new eConsent processes, starting in western New York state, with results to be published later this year.

Fruits of this effort can't arrive soon enough. Without clear consent, some patients will freak out when they see their healthcare data following them around. What providers see as their ticket to ACO nirvana may appear to some patients as a kind of Big Brother, if they haven't been fully educated about all the consent forms they normally sign without reading.

Then there's what I consider the elephant in the room: what the technologists, including Mostashari, describe as a lack of digital key distribution that continues to prevent easy verification of patient identity as patients travel from provider to provider.

The federal government is prohibited by law from being the provider of digital keys that would establish a national patient identification system in the U.S.

This puts us at odds with practically every other industrialized nation on the planet, and hampers our efforts to implement not only ACOs but all manner of population health and public health innovations, not to mention to greatly reduce fraud and waste.

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1 comments on "HIMSS Review: Technology Priorities and Realities"


Frank Poggio (3/12/2013 at 6:13 PM)
Interoperability...a long way off, you bet! And not only that, think of IntrAoperability. But while ONC focuses on moving date between different health providers there are still big – very big – problems in moving data between systems within a given institution. That's even when you have a vendor like Cerner, or Epic, or McKesson as your primary EHR supplier. They are classically awful at talking to specialty systems. At least that's been my experience for 40 years. Typically they are happy to send you data, not so co-operative in receiving it. It gets done, but not without a hodge-podge of interfaces. By the way in looking over the CommonWell proposal it also focuses on external communication. Nice but in my book no cigar. They totally ignore the issue within the institution. I wonder when ONC will figure this out – you can't very well or efficiently create CCD/CCR data without first getting all the internals to talk to one another. Frank Poggio The Kelzon Group