Feature Story

The Doctor Is In: Interoperability Key to Success of Health Information Exchanges

Dr. Keith W. Vrbicky

Yes, the doctor is now in. I'm both honored and thrilled to now be a part of the global IEEE community. Looking ahead, I'll comment on a wide variety of medical technology issues that I hope you find interesting. And I'm always amenable to your suggestions for future topics.

So with my inaugural post, I wanted to talk about health information exchanges (HIE) – key technological advances, what's lacking, what are some of the advantages to doctors and patients, and more.

In brief, an HIE transmits healthcare-related data among facilities, health information organizations and government agencies. They allow doctors, nurses, other health care providers and patients to access and securely share a patient's medical information electronically.

And this timely sharing can also:

Decrease duplicate testing

Avoid medication errors

Avoid readmissions

Improve access and diagnoses

According to EHealth Initiative, a nonprofit organization that researches healthcare technology, there are currently almost 300 HIEs throughout the U.S. at various stages of development. The exchanges, according to Bloomberg News, "have clear benefits, such as letting emergency room doctors look up an unconscious patient's medication history, lab results or record of previous problems. That can help physicians make quicker and more accurate diagnoses."

But while HIE's have been around since 2007, what's still largely missing from the healthcare industry – and HIEs - is what I refer to as Connected Collaborative Care. We need better tools and improved interoperability – in effect – a more comprehensive virtual patient medical file - so doctors can quickly collaborate with each other in ways that are in the best interest of patients.

So what are some integral features that should be part of any HIE today?

Here are a few:

Secure videoconference capability (allowing participants, for instance, to enter a private virtual room). It should be integrated with data transfer that's agnostic to EHR vendors or radiologic imaging manufacturers so data can be uploaded to a virtual patient file (ER, lab, radiology images, voice, video, etc.);

Electronic patient folders that include most types of file formats;

It must complement the current workflow and be able to replace fax, email and courier packages;

Universal access to any authorized provider in any location;

Secure authorized access available on mobile platforms (laptops, tablets, smartphones). The data must be secured by the highest levels of encryption and meet a variety of standards, some of which include FIPS 140-2, DIACAP, ISO 9001:2008 and ISO 13485-2003;

The ability to store and make available electronic patient folders for at least seven years;

HIPAA compliant.

Videoconferencing capability, for example, can eliminate hardware investment -- and the face-to-face communication also helps mitigate any doctor-patient misunderstandings and can improve patient outcomes.

Bottom line? As the fee-for-service model migrates to outcome-based payment, there is going to be a greater incentive to collaborate and exchange data. Personalized cancer treatments based on genomics is already here and is being fast-tracked by the U.S. Food and Drug Administration.

So look for HIEs to further encourage collaboration and educational exchange amongst all stakeholders – and globally!

Questions? Comments? Topics you'd like me to cover in a future post? Reach me at kwvrbicky@aetmedical.net.

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