Electronic Health Record Interoperability Hindered by Lack of Incentives

Aug 12, 2018 | e-Health, Electronic Health Records

TrialSite News staff are intimately involved with health IT interoperability initiatives. The biggest barrier is neither technology nor standards (e.g. HL7, FHIR, etc.).  Of course, technology challenges abound and the market is rife with fragmentation, vendor interest, and the like, but the Deloitte white paper covers a critically important point. Interoperability challenges are primarily organizational, legal and those of business and financial incentive, or “what’s in it for me?”

We have seen a situation where a system we have installed in a state government has certain key social determinants of health data. We met with state information technology executives who said that they would like to access that data (along with other social determinants of health data) to be implemented in big data lakes for advanced analytics, machine learning, etc.  We discovered in that meeting that state level technology executives could not access that state’s own data due to the lack of an intra-departmental data sharing agreement. We further learned that the formulation and execution of such agreements were extremely difficult.  This is all under one state roof! Suffice it to say that those data sharing agreements are still not in place a couple of years later.

We have seen this play out across the USA. Of course, there are forward thinking organizations and entities that manage to foster and facilitate a collaborative culture where more data sharing agreements happen quicker.

For purposes of accessing de-identified patient data for expediting clinical trial patient recruitment there are a number of initiatives and companies innovating in this area–we will post a blog entry on this topic at some point.  However back to the Healthcare IT News piece by Leotina Postelnicu on Deloitte’s interoperability report–highly relevant to clinical research and a union of vision, mission and purpose needs to further evolve in our healthcare world for us to all benefit from the treasure trove of data that exists today.


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