Becker's Hospital Review

HEALTH IT 122 Joe Ganley, Vice President of Federal Government Affairs, McKesson (San Francisco). On government's potential to advance interoperability: "I think it's important that policymakers avoid the tempta- tion to micromanage the effort through steps and an overly bureaucratic system. Government needs to pay attention to the 'what' of interoperability and the 'by when' rather than the 'how' and 'who.' "We need to not lose sight of the fact that the government is a very significant consumer of healthcare. I think the gov- ernment has the opportunity in the mar- ketplace as a consumer to push for more patient-centered interoperability." Bobbie Byrne, MD, System Vice President and CIO, Edward-El- mhurst Healthcare (Naperville, Ill.). On barriers to achieving interoperability: "I have two major concerns with cur- rent interoperability plans. e biggest concern is that we need to get far more sophisticated in the way that patient-spe- cific information is shared, and it needs to be far more tailored to the specific physician. Secondly, we still do not have the financial models in place. Hospitals are paying for service where the benefits accrue to others, especially to insurance companies. Of course, this also gives better patient care, which is why we are enthusiastic participants, but this is not a good long-term model." Dave Garret, Senior Vice Pres- ident and CIO, Novant Health (Winston-Salem, N.C.). On why forcing interoperability will inev- itably result in failure: "Meaningful use requirements dictate we must share data with not only the vendor a health system uses but also a different vendor. ACOs place demand on the need to ingest data from other health systems and physician practices. In addition, the regulatory challenge is always there — legislation that leads to unintended challenges for a provider. "Several state-designated and local HIEs have failed over the last few years, and I suspect more will fail as they find it difficult to sustain a viable financial mod- el. I anticipate more legislative action at the federal and state level forcing aspects of interoperability." Jan De Witte, President and CEO, GE Healthcare (Little Chalfont, Buckinghamshire, U.K.). On IT's potential to transform healthcare: "If you look at this industry, there's a lot of opportunity for health IT to funda- mentally change healthcare. But there may be one stumbling block, and that's data standards — open data standards and interoperability are key. e industry is still in a place where many big players are protective of their data. While there are great solutions out there, sometimes the solutions can't get to the data because people keep their systems closed. We see this in other industries, it's not abnormal. But in healthcare, it's a serious problem." Jim Ingram, MD, CMO, Green- way Health (Carrollton, Ga.). On interoperability across the care continuum: "e reality is that it's like building an interstate system. We did it backward. First, we built all the systems within cities, then we tried to build connections in-between. It would've been much easier to build the connections first. As a result, we lost the ability to pull information from other systems." Judy Faulkner, Founder and CEO, Epic Systems (Verona, Wis.) On Epic's interoperability, and defending it: "e whole concept of being open and allowing users…to be able to use the exits to do whatever they want was in [the platform] from the very, very start. "If we don't speak up, people will be- lieve what others say about us, and an un- answered accusation becomes seen as the truth if you don't respond. We're now in a position where we have to [discuss our interoperability efforts]." John R. Graham, Senior Fellow, The National Center for Policy Analysis (Dallas). On funding an interoperability 'unicorn': "Evidence from Congressional inves- tigations suggests that meaningful use bounties have encouraged the adoption of EHRs that are deliberately closed to exchange with other parties. e problem is that exchanging data with competitors is fundamentally against the self-interest of the party which created the data. "e amount of government funding required to overwhelm competitors' re- sistance to doing this would surely not be worth it. "Congress should be very skeptical of appropriating yet more funding to hunt this unicorn." Michael McTigue, Vice Pres- ident of IT, Barnabas Health (New Orange, N.J.). On what he would do with IT legislation if given the authority: "Stop the electronic medical record vendors from gauging physician offices with cost to connect to other repositories." Lisa Khorey, Executive Direc- tor, EY Advisory Health Care On leveraging the patient in interoper- ability: "It remains a challenge to bridge the gap between what providers should do in terms of sharing electronic data and what they actually do. Absent an interop- erability program that supports broad data exchange, many clinicians and staff receive patient requests for data without a means to fulfill them. Directing patients to a portal is a fine start, but data trapped in the portal of an EMR is still trapped data. "Interoperability is defined by data exchange, not data at rest. Patients who desire to direct data to their providers are oen served a fax number or asked to print the information so that it can be scanned. Leveraging the patient and his or her data is critical to creating information which drives clinical decision support and results in lower cost and better outcomes. It's a circle, so plan to iterate." n

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