Stage 3 Meaningful Use is still underdevelopment, but certain aspects of it are beginning to take solid shape around health information exchange (HIE).
Having approved recommendations from the Information Exchange Workgroup for Stage 3 Meaningful Use, the Health Information Technology Policy Committee (HITPC) has put in the hands of the Acting National Coordinator Jacob Reider, MD, ways that EHR-supported HIE can be improved in the third phase of the EHR Incentive Programs.
The recommendations cover three subject areas: queries of patient records, provider directories, and provider data migration and patient portability.
For the first area, the HITPC is recommending that EHR systems have the ability to both search for patient information (“electronically query external EHR systems for patient medical records”) and respond to these searchers (“electronically respond to electronic queries for patient medical records from external EHR systems”).
In order for these capabilities to be put in place, the HITPC has provided five principles for creating the requirements and standards to be used to support query-based exchange. The main goal of these principles to develop continuity between earlier stages of meaningful use, to simplify the number of processes necessary for query and response, to provide flexibility for users and their workflows, and to detail the abilities that EHR systems must have in order to support these transactions of data (e.g., authentication, authorization, patient-matching).
The second area deals with provider directors. In particular, the HITPC point out the need for searching for a provider and responding to these searches. In a similar fashion, the HITPC’s comments offer guidelines for establishing standards for provider directories that will lead to simplified processes for users built off of the infrastructure developed in Stage 1 and Stage 2 Meaningful Use.
The third and final area covers a topic distinct from the other two. In short, provider data migration and patient portability takes aim at ensuring continuity of care. It concerns the ability to port information from provider to provider and EHR system to EHR system when a switch is made.
According to the HITPC, the goal is ultimately for patient switching providers “to have their care continue seamlessly (no repeat tests, missing key clinical information etc)” while for providers switching EHR systems “to continue providing seamless care to patients (coded data in old system is consumable by the new system so clinical decision support still works).”
For this subject, the HITPC is recommend that the HIT Standards Committee create standards and technical specifications based on its identification of the elements of a core clinical record necessary for improving data portability for patients and providers as well as its investigation into the “adoption of a core clinical record that is easily extractable and consumable by EHRs” and thus capable of supporting this data migration or porting of data.
Concomitant with these recommendations to the HIT Standards Committee, the HITPC is asking the ONC to identify policy and mitigate concerns in the way of facilitating patient portability and provider data migration portability.
