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Interoperability Challenges in the Pursuit of Patient Access
By Elizabeth McElhiney, MHA, CHPS, CPHIMS, CRIS Director of Compliance and Government Affairs
Verisma
May 17, 2024
I recently had the honor to moderate a panel with really engaging, super bright, and deeply invested panelists who are looking at patient access from three perspectives:
- Health Information Management (HIM)
- Patient
- Patient Advocate
Key Challenges
We discussed how many places HIM professionals need to go to assemble a patient’s complete medical record within one organization. Chances are high that it’s not one electronic medical record (EMR). Often, hospital records and outpatient clinical records are in multiple systems. There’s also paper, microfiche, independent labs, imaging, and coordination with different providers and pharmacies to tackle. From a patient and patient advocate perspective, navigating the U.S. healthcare system to access protected health information (PHI) is also far from easy. In some states, consumers need more than one consent to release information. There are numerous usernames and passwords to remember when trying to access portals. These pose challenges even before acknowledging language and literacy barriers. Anna McCollister, member of the Sequoia Project’s Board of Directors and advisory committee member for the Health IT Advisory Committee (HITAC) at the Office of the National Coordinator for Health Information Technology (ONC), perfectly illustrates the complexity of living with complex, chronic disease. She’s asking health technology companies to think beyond what they’re in charge of. For consumers to feel less of a burden, health tech needs to understand their focus area is part of a much larger picture. Anna’s requesting a seamless platform, so consumers can see all their data in one place – saving valuable time and effort. This tool is even more important for patients who aren’t feeling 100 percent, and don’t have excess energy to give.
Managing PHI
Vong Miphouvieng, Vice President of HIM and Clinical Documentation Integrity at a large health system in Texas, agrees EMRs have made it somewhat easier to access data, but not everyone wants to use a patient portal. They partnered with Verisma to simplify access, creating a consumer-focused health system. With interoperability, patient information can now be obtained from one location. No matter where consumers receive care, there’s one phone number, one website, one email, one place they get all their health information. The provider also extended call-center hours, making it easier to access information in myriad ways via portal, snail mail, or walk-in – providing various methods to fit consumer needs.
Veronica Richardson, Vice President of Integrity at Preferred Family Healthcare (PFH), details challenges their transient clients have with mobility. Some don’t have smartphones to request information, and staff can’t always contact them either. They’ve also centralized the release of information (ROI) process so there’s one Dropbox. No matter where patients receive care, they can request records from PFH.
Government’s Role
Data rights need to be more visible when consumers are trying to access information in their provider’s office or in a patient portal. Required alerts describing patient rights, what’s available to be accessed in a portal, and who to contact if consumers can’t access data in a timely manner, need to be front-and-center – along with government contact information to report violations.
Bottom Line
We’ve been talking about interoperability for years, but there’s more work to be done to achieve seamless information sharing between healthcare providers and from one EMR to the next. The process to download, print, mail, and PDF data for integration into the receiving provider’s EMR is still daunting. Consumers are rightfully demanding faster turnaround times, and interoperability is the key for better patient access. The good news? We all know what’s needed. Together, we can define the remaining barriers, outline what’s keeping us from knocking them down, and define how we can work with the healthcare ecosystem and policy makers to get us to true interoperability.