February 23, 2010

Extra Motivations Needed For HIE Participation by Health Systems?

Filed under: CMS,EMRs,HIEs,Meaningful Use — HankMayers @ 12:29 pm

Now that the federal HIE Planning & Implementation grant awards are behind us, and work gets uderway, I find myself considering the criticality of the active participation by health systems in such HIEs. After all, the hospital usually owns the principal ED, and such central ancillary service providers as the major laboratory and radiology/imaging departments that serve the community. Electronic exchange of orders and results information with these ancillary entities is a major priority in the federal EHR incentive meaningful use criteria for eligible practitioners.

In spite of the fact that HIEs are a linchpin to interoperability, the federal meaningful use criteria for hospitals does not cite any requirement that the hospital EHR incentives require participation in multi-stakeholder HIEs.

Comments anyone?


  1. Chris,While this isn’t scientific at all, I think that the chgnae in these systems will be pushed forward by how the providers are paid (as you outline here). Yes, the Government will mandate it, but I think it will move to the integrated and seamless point through pressure from doctors and patients.While I feel it is true that most of the old guard physicians will resist this effort (along with their powerful lobbyists), I am seeing more and more doctors on laptops now. Granted they are logging into 3 different applications to see x-rays from one provider, the MRI from the other provider, then the medical records from their own system. But, that tide is changing and I think they will continue to push this as they are already starting to demand it on their tablet PC.We always hear that the patient plays a key role in managing their health. I’m seeing a tide turning, even within my own company, of patients asking questions about costs, and expecting a better patient experience. I expect not to have to go by my physician’s office to pick up an x-ray to take to the specialist I need to see, and I’m not going to allow the specialist to just take another film and bill my insurance. I know it will come back to impact my premiums sooner or later. I’ve started taking pictures of my own films and emailing to myself to use later, if needed. Lab results the same way. I’ll let the Cloud (Google) handle the security of my medical records.Bottom line, Government will push out the carrot and the stick, but we know from history this will cause a flurry of poor decisions on how to come into compliance. The market will dictate that compliance isn’t what we are looking for, and, sooner or later, logic will take over and healthcare will figure out what global organizations have already figured out with their very sensitive financial data How to share it with all the stakeholders that need it, both within their company and outside (Government, shareholders, regulators, etc.).My bigger question is how we get Healthcare to speed this learning curve up? Is it adopting a standard like Tom suggests? I’d love to hear your take.

    Comment by Anazilde — October 13, 2012 @ 8:56 pm

  2. This is a pretty ruucidloes story. The CCD is an HL7 format. What HITSP adopted and sent to the Secretary was not the CCD but the C32, a sort of CCD lite. Why the journalistic silliness? It is one thing to protect your sources, it is quite another to keep the name of the subject of a story secret. That borders on gossip not news.[from Evan Steele:]Jim,Because EMR Straight Talk is read by people with technical backgrounds like you, but also by people with non-technical expertise, this post addressed the issue at a high level, without including the details related to the various HL7 formats. You are technically correct that CCD is an HL7 standard (part of the CDA HL7 3.x framework), however, when I referred to “HL7 formats,” I was talking specifically about the HL7 2.3 and 2.5 standards. It requires several 2.3/2.5 messages to transmit the same set of information that is encapsulated in one CCD message. This is why instead of sending this particular HIE one CCD, we are required to send them ORU, ADT, MDM and other types of HL7 2.3/2.5 messages which all have subtle differences. Because CCD is so much more comprehensive than the traditional HL7 2.x messages, the interfaces focus on the delivery of one message in one format, significantly reducing overall costs.

    Comment by Aakash — November 19, 2014 @ 11:29 am

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