improving interoperability than any of the cross-vendor networks that have been formed to date, according to a Klas survey.
“I think Klas is right in that CommonWell and Carequality are inherently limited in their scope by the commercial arrangements around them,” Grieve says.
Lack of Identifier an Obstacle
Medical records software companies are often the ones blamed for making records less portable, but some industry observers contend the federal government could do more to enable record sharing.
In fact, that was part of the original intent of the landmark 1996 law, the Health Insurance Portability and Accountability Act (HIPAA). According to a 2009 book by researchers at the Institute of Medicine that analyzes parts of the law, it included a directive for the secretary of the U.S. Department of Health & Human Services to come up with “standards for unique health identifiers for patients, employers, health plans, and providers” across the nation.
But within a couple years, that changed. When deciding on appropriations for fiscal year 1999, legislators added language to the bill saying federal funds couldn’t be used to support the creation of a nationwide patient identifier. The same language, which was born out of patient privacy concerns, has appeared in appropriations bills every year since.
“The single biggest information block is the federal government’s block on having a single patient identifier,” argues Grieve, the FHIR co-leader. “Matching patients is hard and expensive. [In] Germany, everyone gets a healthcare identifier at birth, and it saves them lots of money for exchanging data and building clinical interoperability systems on top of the data.”
Between 8 and 14 percent of medical records contain inaccurate information, owing to a mistaken patient identity, according to industry estimates. “The result is increased costs estimated at hundreds of millions of dollars per year to correct information,” along with potential hazards to patient safety, according to a 2012 Healthcare Information and Management Systems Society report.
The auto industry faced a similar problem until 1981, according to a report on the website Healthcare IT News. Even though the National Highway Traffic Safety Administration introduced the vehicle identification number in 1954, for decades, manufacturers used different formats for the identifier. When the federal agency standardized the format, it became easier to track thefts, recalls, and collisions.
Time will tell if the government takes similar action in healthcare.
