A Road Map for States: Addressing Privacy and Policy Barriers to the Availability and Flow of Electronic Health Information

Lucia Savage and Peyton Isaac | December 9, 2016

Data show that individuals expect to be able to access their health information, making it readily accessible and securely shared among their health care providers to support effective clinical decision-making. And here at the Office of the National Coordinator for Health Information Technology (ONC), we are committed to providing the electronic health information infrastructure to support the nation’s transition to a health system that rewards quality over quantity to achieve better care, smarter spending, and healthier people.

Yet, as described in Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Road Map, multiple and diverse state laws for health information privacy and confusion about the Health Insurance Portability and Accountability Act (HIPAA) often prevent health information from flowing where and when it is needed. These barriers to the seamless and secure flow of electronic health information can also be exacerbated by organizational privacy policies that fail to take advantage of how HIPAA can support exchange of health information, or slow adoption of technical solutions that can help facilitate both privacy compliance and exchange. While we have worked with the Office for Civil Rights to produce consumer-friendly resources to address some of these challenges, we know there is still work to do, particularly with our partners in state governments.

That’s why ONC awarded a cooperative funding agreement to the National Governors Association (NGA) to identify potential steps that could improve the flow of electronic health information within, and among states. Today, we are thrilled to announce that, under that agreement, NGA has released a comprehensive road map for states to improve interoperability: Getting the Right Information to the Right Health Care Providers at the Right Time: A Road Map for States to Improve Health Information Flow Between Providers.

NGA interviewed more than 90 state health policy officials, health information organizations, vendors, provider organizations and payers, and convened 30 officials and stakeholders from the federal, state and industry sectors to discuss the problem. The NGA road map helps states evaluate their own legal and regulatory privacy landscapes, identifies best practices states can learn from each other, and enables states to take decisive steps to improve the availability of electronic health information while simultaneously protecting patient privacy.  In addition, NGA also found that key market issues are negatively impacting whether health information exchange is occurring. For instance, NGA found that many opportunities remain for state policy makers and health care leaders to improve information flow by transitioning to value-based rather than fee-for-service health care payment, as reflected in the new Quality Payment Program announced in October to implement the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

Not only has the NGA published its road map, it has begun assisting several states in executing the road map’s recommendations. NGA will issue a report on these efforts next year. We look forward to continued collaboration with NGA and state governments, policymakers, and private sector health care leaders to alleviate privacy policy barriers in order to achieve our vision of truly seamless and secure flow of electronic health information when and where it matters most for individuals, clinicians, and communities across the country.