Key Step Toward Nationwide Health Information Exchange
Today Health and Human Services Secretary Kathleen Sebelius announced the awarding of over $160 million in new grants to help states advance the adoption and meaningful use of health information technology. This completes the final set of awards as part of the State Health Information Exchange Cooperative Agreement Program, which was authorized by the American Recovery and Reinvestment Act of 2009. The first wave of 40 awards was released in mid-February. Through this final round of awards, every U.S. State and territory, or their State Designated Entity, has now been awarded funds under this program.
As part of this round of awards, 16 states and qualified State Designated Entities (SDE) will obtain the resources and technical assistance to rapidly build capacity for exchanging health information among and between health care professionals and hospitals. Such exchange will allow any two providers in a state – and ultimately across the nation – send and receive relevant clinical and other data necessary for improved coordination of patient care. Recipients of these awards will establish and implement appropriate governance and policies and ensure the necessary technical infrastructure and business operations are in place to support secure exchange within and across states.
An unprecedented level of coordination and collaboration is needed to achieve our vision of a secure, interoperable, nationwide health information infrastructure where health data can follow patients to their point of care. We must find innovative ways to break down the barriers that prevent the seamless exchange of information, and States have to be key players.
I congratulate each grant recipient, and welcome a dialog on the role of states in advancing our challenging agenda.
–David Blumenthal, M.D., M.P.P. – National Coordinator for Health Information Technology
Good NEws!!!!
I applaud this news. We need to do everything possible to aid health care information reaching the practitioners. Health care cost are way out of line with all other industries. Any help in containing cost is welcome.
great news, didnt the hc reform jsut hapen?
I have a proposal … Health IT should go hand in hand with the latest health care reform.
I wonder to what degree the proposed EHR design will be influenced by the insurance industry which is primarily interested in profits (by limiting, among other things, physician reimbursement) as opposed to physician input. I expect that the new system will conveniently facilitate review of MD activity in order to limit MD services.
This is a good idea that’s finally moving forward I hope. The only problem I see is the cost of the technological hurdle of making everything work together seamlessly. With time and money, this can happen.. and in the long run it’ll be less costly, I’m pretty sure.
It would be quite costly to have seamless exchange of patient information. Gov should definitely collaborate with the private sector in realizing this project. Nonetheless, it’s great news.
It would be nice for the health care worker to have accurate information, immediately accessible. My trepidation is based in that old saying “Garbage in, garbage out.” If the health care worker relies too heavily on the record and doesn’t notice the patient, the patient may become the garbage out.
I really agree with this. We can look at all the related information written by other busy health care professionals and once again ignore the person sitting in front of us. This is one of the most important downfalls of our existing health care system – lack of real contact with the patient.
This is great news. I’m concerned about the security issues that come with implementing such a widespread system though. With access points in large number spread all over the country, security breaches can emerge from everywhere. But hey, this system is unavoidable and deeply needed.
Hmm interesting concept and i see the hurdles what have to be crossed before this can be realized. The only thing we know is that technology won’t get cheaper so the faster this concept is implemented the better it will be and probably it will save money and life also.
Which states qualified for the State Designated Entities? I am curious because I know that correct information/communication in the medical field is the difference between medical malpractice and a successful operation.
So the problem these hundreds of millions of dollars are intended to address is to create an infrastructure so that “health data can follow patients to their point of care”. Is it no-longer my personal responsibility to request the forwarding of my medical records to a new doctor? If I have a medical condition and travel across state lines, or even outside the country, would it not be prudent to bring my medical records and prescriptions, etc. with me? Sometimes, I have to wonder how my parents lived to a ripe old age without the government’s assistance. How many citizens could possibly have a need for this service?
You would think in this country , at our stage of development and we are behind some european “third world countries”
Come on Obama get it together.
Won’t such a widespread system come with a lot of loopholes. I’m all for progress, but this could mean breaches galore now. What are you doing on the back end to secure the system against that?
I think the move toward being able to share and track health information is a necessary and valuable one, although not without certain risks (i.e. privacy). But even with potential privacy issues, the benefits that stem from more accurate data following individuals from health care appointment to health care appointment can only be a good thing.
Physicians are incredibly intelligent individuals, however they are not mind readers. Given them improved tools and information to help them better perform their jobs – this is an idea I fully endorse!
I am Sure Kathleen Sebieius (Former Gov. Of Kansas) has good intentions. For hospitals to go to totally digital technology is great assuming these systems would not be compromised. Although it will be difficult for smaller rural hospitals with a smaller balance sheet and less gov. funding to accomplish this goal.
“Secure” is a key word here. It’s important to remember that the more entities share your health care information, the more possibility there is that that information can get into someone’s hands you may not want it to get in to.
As a health insurance agent, I look forward to the use of technology to help eliminate the waste that translates into increased costs and less coverage for our clients.
Thank you!
I am all for free exchange of info, but I agree with some of the other posts here about “security” of information.
I hope that we can find a safe way to make it easier to share information while at the same time making it secure and safe from hackers out there.
Jeremiah
I’m curious if they’re making progress with this.
We’ve had the internet for far too long for our health information to NOT be easily accessible by health care providers. The current system is in the dark ages and makes no sense! Health care costs will continue to spiral out of control if they can’t improve the systems that they use.
I think with the growing rate of condistions such as cancer, obesity, heart disease, etc it is vital that some kind of info network for health records is set up. We need to ensure that people are always getting the care they need no matter where they go.
The principle of data exchange between medical centers across and between states is a key deliverable if we are to reduce the percentage of GDP that is being spent on health in the US. The challenge is to not let any one interested party determine the implementation – it should all use agreed, international standards for interoperability and then every provider can contribute.
Mike Allen
While the idea of being able to access records nationally is a good idea on the surface I fear that this could lead to problems as data would be more susceptible to being hacked and misused. Just my .02
While I agree that we need to share information I have two worries. The first is security. Nothing will be 100% secure and I would be very very nervous if all a patients info is out there for anyone who can hack it.
The second point is how does this affect the small business doctor. I am talking about the family doctor that has a small family practice. Will the cost of this be so prohibitive that he/she won’t be able to participate, therefore getting left behind?
If this had any real value to patients or physicians the marketplace would have made it happen already.
I think a national system is a fantastic idea for any country. With a system like the one proposed the chances of mediacal mistakes being made are significantly reduced and the potential time and money savings are huge.
The downsides are the cost of creating and maintaining susch a system. Here in the UK millions and millions of tax payers pounds have been pumped into a nationwide system for patient records and the costs have gone up and up and up and the system is still not up and running.
I welcome the idea of what is being proposed but the reality of it is lagging far behind the potential.
The UK has a similar I.T strategy to provide seamless access to patient records across the NHS. It has proven to complex to implement and is continually under review. Most of the I.T suppliers have abandoned the project. I.T as a discipline is still too imature to handle multi billion dollar projects. One can still argue that the money should be spent at the prevention end of things rather than the cure. People are getting lazier and fatter and children are starting to die before their parents in greater numbers. The health industry is fighting the fast food marketing industry and I know who is winning.
Electronic Medical Records are the future. Considering how busy everyone is these days we do not have time to sit down and wait for a fax to come through of a patient record that is useless. You’ve seen your doctors handwriting. As long as the data is secure there should not be a problem with sharing information across the web.
I agree with most of this blog post but my mind is worried about two ideas.
1) How does this affect to a rural doctor who mainly carries a small business. Concerning small rural medical facilities this concept can be so prohibitive that rural doctor won´t be able to take part.
2) My second worry is about safety and security. Nothing will be 100% secure and I would be very very nervous if all a patients info is out there for anyone who can hack it.
Great post anyway!
I’m all for improved technology and patient care, but $160 million could go a long way for preventative care. What criteria was used to decide that allocating this much capital for technology was more important than preventative strategies for weight loss, asthma, and general well being.
Anyway that we can improve communication between health providers is a step in the right direction. I just can’t help but think about prioritizing major issues though…
I agree that sharing information is critical to efficiencies I am concerned about the integrity of the data and the ability to keep it secure. There are seemingly more and more instances you hear of where secure information is not as secure as it needs to be.
Coming from the insurance industry I can see the real value that the Health Information Exchange would bring from a level of care standpoint but also as a way to mitigate expenses.
In this ever growing world of the Internet it is inevitable that these kinds of systems will flourish and help both professionals and the people they serve. Security is always going to be an issue. But progress marches on. I agree with James above that keeping costs down is also very important, but efficacy is the most important thing.
On the surface this appears to be a good idea, but I too am worried about possible security risks at this type of information being so readily available. And the previous commentor is right about IT being in the slightly ‘immature’ stage. Maybe the timings not quite right yet…
I’m happy that there is a significant amount of money being allocated toward helping progress the (behind the times) information technology of the health industry.
This seems like great news to me. Of course we’ll have to see how it turns out in the end, but I agree that we need to do whatever we can to aid health care information reaching practitioners and others who need it
Thank you for this post
Although I agree with the fact that we must reveal important information, but I’ve a couple of doubts. The very first is about safety. If you do not be totally safe I will be extra stressed if all of a patients information is accessible for anybody who may crack it.
And for hospitals to attend completely digital technologies is excellent supposing these systems wouldn’t end up being compromised. It might be great for the healthcare employee to acquire appropriate information, instantly accessible. However it can be hard for smaller countryside hospitals with a limited balance sheet and much less gov. funding to achieve this objective.
Is it really that great of an idea to have all of our medical records available on one database? I just see the potential for abuse as outweighing the potential benefit. Seems to me like the money could be spent to help improve people’s health rather than updating information systems.
It is, indeed, a good initiative to exchange medical information nationwide. The easy access to medical information should foster innovation, rapid development of drugs, and improved effectiveness in treatments. Ultimately, it should directly impact the underprivileged and poor to get benefit of better access to medical care.
Good and relevant perspective with many points that hit home. I would add that regardless of any specific challenges being faced or introduced, we are all faced with this great and awesome opportunity to transform healthcare. Yes, it may fall short on funding, has many conflicting requirements, confusing market forces and inefficient execution, but we cannot nor should not ignore that the opportunity is here. And people like you and I are starting to participate and act in moving it forward. Therein lies what I believe will either make or break this transformation – you and I, individuals working with all levels of public and private sectors in ensuring meaningful achievements and actually creating and driving the market forces.
Greetings! Miguel
I’m concerned about the potential security issues that come with implementing such a widespread system though. With many different access points in large number spread all over the country, security breaches can emerge from everywhere. But hey, this system is unavoidable and deeply needed.
I totally agree with you, it is very important to the industry to have the ability to exchange data via healthcare nationwide. Thanks for the info.
It shocks me, in reading these posts, how many people think that this is too much of a security risk to implement. I mean, seriously, you don’t pay your credit card bills online? You don’t do any online banking? We’ve all heard the stories of such and such data base getting hacked and yet we still do these things because we know the risk is minimal, but the convenience factor is huge. But when it comes to our safety, and doctors getting information fast and accurately, it’s too much of a security risk? I hope none of you are ever in a situation where it’s imperative to get all your medical records immediately, but if you are, don’t you think that you and your family would feel safer knowing that you’ll be taken care of to the best ability of the doctor you are seeing?
i think this is a great step forward. not only will it make information easier to get but it will also be faster and more efficient. and i would rather have my doctor wherever they might be able to see my past medical records as fast as they can in a time of medical need.
and i think this is worth it and i don’t think privacy will be as big of a problem if handled right, which is most likely will be.
$160 million is a lot of money to be throwing around. Wouldn’t this be better spent trying to prevent health conditions and promote awareness of things like proper dieting and exercise rather than trying to cure people for things they already have?
Prevention is better than a cure.
Are there any security risks involved here? Electronic data is easily passed on and often highly valued.
From what I can see the health industry, state and the fed will be opening a flood door of law suits.
They are making themselves responsible for private health information that they can’t possibly make secure.
The effect will sky rocket the cost of health care.
As a UK practitioner I warn you that integration is the difficult step. With so many legacy platforms to accommodate and such a massive infrastructure base to implement, it could be a very rocky road. We haven’t done a very good job here, but the system is finally starting to deliver some patient benefits. However, I’m not entirely convinced the time, effort and cost has been worth it.
I’ve worked in HealthCare IT for the past decade, and all I can say is that I hope the funding the government puts toward electronic healthcare records ends up being used to get some semblance of order and standardization between applications.
I find it most interesting that PACS technology and other imaging technology is racing along and is very cutting edge, but the medical records portion of health care IT – is simply archaic. Not to mention the fact that so many applications or modules have to communicate via HL7 (which is a common protocol), but they still have to go through interface engines to get the messages to sync up. It just takes one bad HL7 message to screw up a patient record in several downstream systems. Very painful.
I really do hope that some more funding can be pushed out to developers to work in conjunction with real world providers and IT support staff to provide solutions that give patients the best quality care and minimize the tangled web of health care IT as it stands today.
Anytime barriers to open communication can be broken down is a good thing. The technology exists to provide health care data and records while still maintaining privacy. What is lacking is a system to pull all of it together.
I applaud the grants. Technology as we know is the way forward and if we can spead up the awareness of health care issues the better.
While I agree that we need to use technology to improve health care, I am concerned with the security and potential misuse of the data, and the growing government intrusion into our personal lives. For example, the new government regulation that doctors record everyone’s BMI (body mass index) in an electronic data base at each visit. It seems that almost daily there is another news report of a computer security breach which exposes massive amounts of personal data. I have personally been notified 3 times by various financial organizations that my data has been compromised. It is bad enough when its your social security number, but what happens when sensitive health information is exposed and available for anyone to see? Do you want your neighbors, your potential boss, insurance companies or criminals to find that kind of personal information online? And there are other issues: Who controls access to your personal data? Do you have right to see it? Do you have a right correct or edit it? I hope these important issues are addressed early in the process, and not ignored until it is too late.
It will give any Doctor the ability to see if a person has any special health needs regardless of where they are from. This may save lives.
As an IT professional for 25 years I must say: “it’s about time! If something happen to me anywhere my hospital or doctor should be able to pull my information at any place at the point of care. Much care should be taken to protect this information because now that it will be digitized it can quickly wind up anywhere in the wrong hands.One way to protect this info is as simple as when you register for a service online a four digit code will be given to you or when you get your Med Card a code just like today will be on the card. this info combined with other personal info is used to access your information over the internet if you are not at your personal physician. Your doctor has your information already so he does not need this code but if you are somewhere else this code must be entered to access your records this means that you are in control of your records, just like your online bank account. A process however need to be put in place in case of emergencies. To make it even more simple, it can be the last 4 digit of your social security, many organizations like banks and other services uses the last 4 digits of your social security in combination with other info.Again this is just one way , your medical card can also be used? Great job Secretary Kathleen Sebelius keep up the good work and keep on pushing until its done!! This is good for every tax payer if done right,,, lower cost,,, better health care,,, fewer mistakes etc, etc, etc.
To be honest, i cant belive this hasnt been implemented already. I work in IT and I cant see that this would be so difficult to do. Furthermore, for helath care in foreign countries being able to access data across seas is the next step. I hope to see this happen within the next 10 years. Alex
PACS imaging is already advanced and I have some difficulty understanding what exactly $160,000,000 is going to do for patient information that is for the most part text anyway. While patient images travel on “state of the art” networks and computers, radiologic transcription and reports hang out on 8086 level computers, having transcribed many of these reports myself on totally archaic software. Until the individual players (hospitals) realize that you have to spend some money on software and computers for reporting and patient information (not just imaging) not much will change. Gentlemen, we already have the technology to handle patient information. We just need to implement a protocol similar to the internet to handle this information. Somehow, I don’t see that protocol development costing $160,000,000. Maybe it would be better spent as “Family Health Insurance Rate” says on prevention of disease.
Sharing of information is a good thing. It can save lives, make for better decisions by doctors, allow for more and better collaboration.
Security of one’s personal data can be a concern, but let’s not be naive and think just by not doing this personal data is anymore secure. Our personal records are already all over the place, on paper, on computer hardrives, on the net. I hear stories all the time of a laptop or memory stick going missing with someones personal information on there or files just being thrown in the garbage.
It is time high time this happens.
Wow its about time! I cannot believe it has taken them this long to change our medical records into an electronic database accessed by any doctor anywhere. Just think of how many lives this will save, and how much easier it will be for a doctor to make a proper assessment of a patients condition if they now there past medical records. It will be a huge undertaking, and their will be allot of bugs to work out but it will streamline the health system. I would like to see a complete world organization that allows pertinent medical information to be accessed by any doctor treating your condition.
Ten years ago I was working in the smart card industry on health care cards. The idea being that you could carry your complete medical information with you on the card. The idea never took off as “new” developments in web technologies were predicted to make the information securely available on-demand, any time, any where without the use of the expensive card. And a decade later with the web technologies firmly in place? We still aren’t there. This is long overdue. Good news to see at least some progress is finally being made.
Excellent initiative. The rapid & accurate exchange of information is vital in the health industry. The challenge (and opportunity) will be the co-ordination/co-operation of states and the various database systems. If we can map human genomes then surely we’ll overcome minor technology issues to enable a seamless operation of such a nationwide health initiative. Everyone wins.
Most of the issues are not technical. See my post
Recently within our family we have had to wrestle with this issue. My 85 year old grandmother had a stroke and her (almost) 90 year old husband is suffering from dementia. Gaining any useful information about their health has been quite the struggle. Moving them into our home was relatively easy, but getting their health care records has been almost impossible. While my grandparents didn’t plan very well, it shouldn’t be such a huge burden for family and caretakers to assist the elderly and infirm. I applaud this progressive approach to information exchange.
It’s a shame that any kid can create a cookie on his website that will follow you and track your web site usage, but our health care system is still having trouble keeping track of patient records.
Recently within our family we have had to wrestle with this issue. My 85 year old grandmother had a stroke and her (almost) 90 year old husband is suffering from dementia. Gaining any useful information about their health has been quite the struggle. Moving them into our home was relatively easy, but getting their health care records has been almost impossible. While my grandparents didn’t plan very well, it shouldn’t be such a huge burden for family and caretakers to assist the elderly and infirm. I applaud this progressive approach to information exchange.
Last week the Maryland health information exchange that will allow hospitals, physicians, labs and radiology centers to share patient information went live last week.
Three hospitals, plus three radiology centers, currently participate in the exchange while another all 48 Maryland hospitals have signed letters of intent to join the exchange over the coming months.
Their goal is to serve the entire Maryland health-care community with the hope that eventually all the hospitals will connect and all of the ambulatory care settings will connect as well.
This process is moving forward faster than most would have anticipated.
I think the sharing of information by health care officials is a good thing. It can help doctors make quicker and better decisions and save lives.
Not much of our personal data is really personal anymore. Banks have it, airlines have it, insurance companies have it, credit card companies have it, employers have it — heck I could go on all night.
If all of these already have it, why shouldn’t someone as important as a doctor or hospital have it.
I am for it.
Full disclosure: I am an Health Information Technology professional. I’m one of those guys that work on this day and night. Been a bed side clinician and am a trained informaticist. I echo the “it’s about time” sentiments but it’s not as easy as throwing a switch and saying “let there be information exchange.”
Most of the impediments to getting health information exchanged are based on the following issues: There is very poor national and state policy to support this. ONC is trying to change that but it will take more…much more. Next: The legal framework of each of the 50 states and territories almost make it impossible to exchange information across state lines despite the technology to do so. While there is progress in this area as well, we have a LONG, LONG way to go.
Another fun fact when you talk about this: You say you want your health information but riddle me this, who’s going to pay for it? You? many of us can’t afford the insurance premiums we fork out each month. Information exchange costs money…and lots of it. The Recovery Act spending on health information exchange is spread out over 3 years with no guarantee of that funding continuing. States won’t / can’t pay for it or they won’t do it in the levels it’s need to get the job done. Insurance companies won’t either. Funny when we talk about information exchanges, the health plans aren’t paying their fair share but they sure do benefit from getting all your data!
Hospitals? Forget it. Again, they want it…kinda… but they don’t want to pay for it.
That leaves the docs generate most of your health information who simply can’t afford what it will take on a year to year basis to exchange it electronically. Another thing: while as patients we all feel this is a wonderful thing…and it is. It will keep us safer and give us better access to our information but hold on a minute. The docs “own” the records as per many state laws. If you think your friendly neighborhood doc is going to give you free and open access to his records, think again. And these docs don’t necessarily want the information you keep for your own use as more and more of us are doing. (I keep a Personal Health Record electronically). And this doc doesn’t think all of this health information technology being exchanged is all that great. It’s expensive. It’s time consuming. It’s hard to use and the doc has to change the way they practice. And first and foremost, if the information is exchanged electronically, it better be right and not get messed up in the information exhanges.
At the end of the day, it will take us, the patient’s to demand this to happen for our own well being. We also will need to accept the risks that come with this. Just as mistakes are made in paper charts, they will be made electonically. Hopefully, they’ll be less. We consumers are not expressing their opinions on this to the government (Fed, state and local). We have to demand this. We have to make our lawmakers think this is important to us. Take 20 minutes to write your Congressman or Senator and tell them just how important this is to you. My wife is ill with a condition that will likely cause her death. The reason I do this is because this is personal…and it matters to each and everyone one of you who read this.
My IT team has been working on this initiative since mid 2010. Setting up security protocol and also following these new guidelines and Hippa guidelines has been a challenge. I’m very thankful for this grant though, we’ve been able to add several new qualified IT specialists to our team.
-Ben
We are Chiropractors in Madison AL and one of the largest Chiropractic group practices in the state. A year ago when these grants were announced and the formation of (SDE) State Designated Entities contemplated, we looked forward to tangible results. To date, at least the Chiropractic community in Alabama, we have seen none. We bought into the vision of a secure, interoperable, nationwide health information infrastructure where health data can follow patients to their point of care. It appears that this is again long on promise and short on delivery. Dr Greg Millar
I am Chiropractor from Wichita. And i have also involved IT into my practice. So i think it is a great thing that govt have done.
Sorry to be late to this comment and thread but I wanted to comment regarding the chiropractor above. Most chiropractors in Colorado (I have practiced nearly 15 years in the Lakewood/Littleton area) do not use EMR. I think that a profession-wide movement would help us to be able to participate more in collaborating with other health care professionals. Its more about seeing into the future and having a mindset of collaboration then it is about just the IT.
Many of you raise valid concerns. Today I take note that the US Supreme Court will finally hear arguments on ACA and its validity. If it is upheld then what… Then we in healthcare can start making progress on determining just how EMR’s are going to look, going to be implemented; and, perhaps most importantly, who is really going to pay for them. If dismissed then what… Well most of what we’re all talking about goes away for another day. The worst case is the Supreme Court handing down a yes or no maybe decision. One that keeps ACA but does not clarify the solutions. That would be a disaster for all.
Genetically, I have a weak heart. Many of my family members have died with heart disease as a major factor. I think the hospitals and heart foundations need all the health they can get but in the meantime, the advice I got was to not smoke, avoid salt, exercise and eat right. Seems simple enough to follow and I’m trying to follow it as best I can but any help that can be given to the healthcare structure makes for a good safety net should anything go wrong healthwise.
This is great news. Although it’s a great challenge implementation wise. I hope the government or concerned group combats the challenges to bringing this program into fruition.
This program is great in fighting for health problems like obesity.
$160 million is not bad when pumped into health,health is basic,a healthy nation will lead to more development in any government,the quality of human resource is directly proportional to human health.
A nationwide database must be the foundation of any national heath care policy. This is long overdue. It is something that we must all recognize as necessary regardless of security concerns.
It seems incongruous that we have become blase about having our credit card details, and shopping preferences stored online but we have concerns about having the same for our health records. For sure it is important to have appropriate security measures in place. But the bottom line is that this will save lives.
This is a good idea that’s finally moving forward I hope. The only problem I see is the cost of the technological hurdle of making everything work together seamlessly. With time and money, this can happen.. and in the long run it’ll be less costly, I’m pretty sure.
Thanks David for giving us this update. I think it’s a great idea that healthcare information can be sent instantly between hospitals instantly anywhere in the US. My one concern is that this doesn’t infringe our privacy. Hopefully not everyone working in a hospital has access to this information.
Tony