Reminder: Do not include any PHI or PII in Confluence. If you require 508 accessibility assistance or any other support for this system, then please send an email to onc-jira-questions@healthit.gov
Panelists:
- John Fleming, MD, Deputy Assistant Secretary for Health Technology Reform, ONC
- Elise Sweeney Anthony, JD, Director, Office of Policy, ONC
- John Heil, CEO, Imalogix
- Jordan Everson, Associate Professor, Vanderbilt University
To participate in the discussion please post a comment below. Comments will be made anonymously, if you would like to be identified or contacted after the event is over, please include your name. Your registration email address can then be used to contact you after the event.
18 Comments
Anonymous
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?
Anonymous
Just to clarify, it is not necessary to participate in the App Orchard to build a patient-facing app using the APIs that are identified in ONC 2015 Edition. Open.epic provides those without any fees.
Anonymous
While this may be true for patient-facing apps, this does not hold for clinician-facing apps from the current conversations we've been having with Epic representatives.
Anonymous
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?
Anonymous
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?
Anonymous
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?
Anonymous
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?
Anonymous
Slides please, the screens are hard to see. Thanks
Anonymous
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.
Anonymous
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.
Anonymous
It is a sad state that in 2017 it still costs multiple thousands of dollars to "build" an interface for a specific health care provider between a national laboratory company and a national EHR vendor (CEHRT).
Anonymous
Is this because of a lack of Certification for Lab Solutions? Has it got something to do with proprietary standards? Or maybe something to do with the inconsistent use of nonproprietary standards?
Anonymous
Or is it because there is a revenue stream from "building" interfaces?
Anonymous
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).
Anonymous
Absolutely agree...we need a patient- and clinician-centered approach to measuring interoperability: http://bit.ly/2vszFSO
Anonymous
NQF worked on such a patient/clinician centered approach to measuring interop and has a draft framework: http://www.qualityforum.org/Interoperability_2016-2017.aspx
Anonymous
CentriHealth (now a wholly owned subsidiary of UnitedHealth Group) offered comments on the draft NQF interoperability measurement framework. These comments were submitted 30 June 2017 in response to the NQF call for public comments and are posted here: https://www.dropbox.com/s/37p5e5f2mrihi2m/CentriHealth-Comments%20on%20NQF%20Interoperability%20Assessment%20DRAFT%20Report-ALL.pdf?dl=0
Anonymous
This is foundational and I would highlight the word use! We need to first define the "usages", then define interoperability to align to those usages, and then we can make progress towards prioritized usages and be able to measure such.