Blumenthal: Data exchange barriers need to disappear
David Blumenthal, MD, national coordinator for health IT, issued a letter Thursday addressing the need to eliminate inappropriate barriers to the implementation of Health Information Technology for Economic and Clinical Health (HITECH) Act mandates.

A key premise for health IT policies, Blumenthal wrote, is that “information should follow the patient, and artificial obstacles–technical, business related, bureaucratic–should not get in the way….This means that information exchange must cross institutional and business boundaries.”

Blumenthal noted three barriers that the HITECH Act directly tackles to assist providing patients quality care: commercial, economic and technical. HITECH, Blumenthal said, also provides building blocks for information exchange across jurisdictions.

Noting that the HITECH Act calls for the “development of a nationwide health IT infrastructure that allows for the electronic use and exchange of information and that…promotes a more effective marketplace, greater competition...[and] increased consumer choice,” Blumenthal stated that arrangements cannot be supported that restrict the secure, private exchange of information required for patient care across provider or network boundaries.

The HITECH Act focuses on interoperability--thus policies, programs and incentives must aim for EHR software and systems that can share information with different EHRs and networks, Blumenthal said. For example, under HITECH, the Department of Health and Human Services has been directed to invest in the infrastructure to “support the nationwide electronic exchange and use of health information …including connecting health information exchanges.”

Grants which total $564 million for states and state-designated entities target information exchange across boundaries, Blumenthal wrote, not only within each state but explicitly as part of a nationwide framework. These grantees’ activities must support interoperability that lets patient data follow the patient across political and geographic boundaries, he noted. 

Grant award announcements will begin this winter.

Blumenthal briefly noted that while the official definition of meaningful use won’t be finalized until next year, the HITECH Act specifically highlights “information exchange” as one requirement for the economic incentives.

Blumenthal concluded that “the HITECH Act not only authorizes but requires us to mobilize all our policies, programs and incentives to give the American people the patient-centric care they deserve and expect.”