Interoperability Context in 2017: Business Cases and Information Blocking

Epic recently began requiring HIT vendors to participate in its App Orchard program in order to retrieve a CCD from hospital systems. For most cases, this means the vendor needs to pay an annual subscription fee as well as a recurring revenue share to Epic. There are additional intellectual property rights that vendors must give up, as well.

If the ability to retrieve CCDs is a core component of Meaningful Use, how do the financial and legal implications of the Epic App Orchard model on HIT vendors resonate with the panel?

As providers in the ambulatory setting, we see EHR vendors struggle to keep up with the increased demand to integrate with various other EHRs, payers, ancillary systems, etc.  At what point do the resulting delays edge into information blocking?

Exceptions exist to protect specific patient information from being inappropriately shared, such as self-pay exemptions, minor STD/pregnancy/sexual activity, behavioral science records.  How is the healthcare industry attacking record exception logic and how is the ONC monitoring accountability for the privacy of these recognized reds?

Even though there is a big focus on sharing data with patients, it is hard to do without having a universal identifier for patients. As a father, I do not have access to my children's health data because they do not have social security numbers. Even though SSN should not be used for patient identification legally, without a successful identifier, systems are forced to use it. What is the future of the problem? 

Who should be responsible for filtering patient data on an API - the sender of the record or the consumer of the record?  Moreover, does the industry advocate opening the sharing floodgate to established providers so they can provide the best patient care?  If so, at what point does patient privacy begin to limit this sharing?

Slides please, the screens are hard to see. Thanks 

Many of these interoperability gaps between hospitals are the domain of regional HIEs to act as a hub for clinical data (including discharge summaries and real-time data). This eliminates the need for each organization to make dozens of connections. This can also cut down on the need for repetitive tests and improve care across the board.

Who is addressing the cost barrier to break down data exchange.  The price to share data varies from each vendor,  and each one will tell you, you get what you pay for.

There is marginal value in quantitative assessment of interoperability (measuring transactions fired across an interface or via an API).  What we need is full qualitative assessment (measuring fitness for use).