Health data ex­changes still face crit­i­cal chal­lenges

Modern Healthcare - - COMMENT -

Re­gard­ing the March 3 ed­i­to­rial (“Keep the pub­lic health in­for­ma­tion ex­changes open,” p. 25), pub­lic HIEs are a won­der­ful con­cept, as were CHINs (com­mu­nity health in­for­ma­tion net­works) and RHIOs (re­gional health in­for­ma­tion or­ga­ni­za­tions) be­fore them. While tech­nol­ogy and the In­ter­net have taken some of the chal­lenges from these in­for­ma­tion-shar­ing ef­forts out of the equa­tion, two sub­stan­tial is­sues re­main.

HIEs fun­da­men­tally lack a ro­bust rev­enue model. Pa­tients in other in­dus­tries are known as clients. Get­ting businesses to pay to pub­lish their clients’ in­for­ma­tion for com­peti­tors is a hard sell. Also, con­sumers have an in­her­ent aver­sion to al­low­ing their most per­sonal in­for­ma­tion to be stored or ac­ces­si­ble via a quasi-gov­ern­men­tal en­tity.

The HIE con­cept needs to be re-en­vi­sioned as a con­sumer-cen­tric model where con­trol and ac­cess are based around the in­di­vid­ual or au­tho­rized care­giver (mom, adult child of a frail el­derly par­ent, etc.). Even this model lacks a ro­bust source of rev­enue, but at least is­sue No. 2 is ad­dressed. And con­sumers who learn to own and con­trol their med­i­cal record will find con­ve­niences that force providers to par­tic­i­pate—like not hav­ing to fill out the long form on that darn clip­board.

The ONC seems to be work­ing in this di­rec­tion. Dr. Ed­ward Fotsch

Chair­man PDR Net­work Sausal­ito, Calif.

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