ONC Reports 6 Barriers to Interoperability in Healthcare Information Data Exchange

Recently, the Office of the National Coordinator for Health Information Technology (ONC) filed a 22-page year-end report to Congress to summarize national trends in health information exchange. To help maximize health IT and accelerate value-based care , the report identified six barriers to health data exchange plaguing the industry. Today, we've summarized this lengthy report for you, highlighting the six interoperability barriers.

  1. Technical barriers- A lack of standards development hinders interoperability, along with inconsistent or poor data quality and health data matching issues. Without standardization across these areas, there is no foundation to promote health data exchange. To help, the ONC updated the Interoperability Standards Advisory (ISA) as a set of standards and implementation specifications that advance the seamless and secure flow of electronic health information.

  2. Financial barriers- With ongoing industry regulation and reimbursement program changes, healthcare organizations struggle to keep up with adjustments amidst competing financial pressures. Costs mount to upgrade systems, staff support and optimize IT. The report calls for sufficient incentives for sharing information between healthcare providers to offset operational burden.

  3. Trust barriers- Legal and business incentives block interoperability progress, as health data access is valued as a competitive advantage by some organizations. This approach hinders the core focus of improved, more effective patient care across the continuum. Many hope the ONC will work with Congress to better clarify penalties against information blocking and how they will be carried out. So far the Trusted Exchange Framework and Common Agreement, as overseen by the newly formed Health IT Advisory Committee, is tasked with establishing a set of common principles, terms and conditions to facilitate trust between health information networks.

  4. Administrative requirements- During listening sessions, the ONC and CMS heard from stakeholder feedback that outdated guidelines for evaluation and management (E/M) codes burdened providers while unnecessarily linking payment to documentation. Moving forward with the 2019 Medicare Physician Fee Schedule final rule, CMS says E/M coding will reduce documentation strain and allow greater flexibility to exercise clinical judgment in documentation.

  5. Federal reporting requirements- The ONC said that federal reporting requirements in some cases add burden to healthcare providers, requiring them to report on quality measures that are not relevant or meaningful to their patients or facilities. With the reporting strain, many providers look to third-party resources, like data warehouses or registries, which adds on operational costs. The ONC and CMS vow to continue to listen to stakeholder feedback, pointing to progress with adjustments and leniencies already worked into 2019's Medicare Physician Fee Schedule and Quality Payment Program.

  6. System design and usability- Differences in user interface design across developers also stood out as a barrier in addition to inefficient or unrealistic system workflow. The ONC stated that providers hold frustration with vendors and developers who fail to engage end users in system design and functionality or even workflow automation software selection and utilization.

What are additional barriers holding the industry back with health information exchange? What are steps your organization is taking to stay ahead of barriers?

Stay tuned for additional insight from Stoltenberg on how to strategically propel your HIT initiatives in the value-based care landscape.

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