Patient control is key to data exchange, but faces cultural, economic barriers

The healthcare industry requires a cultural and economic shift to address the overarching issue of health information exchange, suggests David Blumenthal, MD, president of the Commonwealth Fund, in a contributed piece to The Wall Street Journal. To do so, Dr. Blumenthal suggests giving patients control over their data instead of hospitals and providers.

Currently, health information exchange is largely prohibited by conflicting interests by competing economic entities. "Health providers' data about their patients is a valuable economic asset that some doctors and hospitals are understandably reluctant to share with their competitors down the street. Many patients stick with clinician and hospitals in part because that's where their records are," Dr. Blumenthal wrote. "If the records can travel, so may patients, taking their business with them."

Essentially, healthcare organizations have no incentive to share this information. Instead of provider-facilitated information exchange, Dr. Blumenthal suggests a consumer-mediated health information exchange where patients decide who has access to their information.

Under HIPAA, providers are required to share patients' records within 30 days of a request. If patients were to take control of their records, they could move the information as needed, suggest Dr. Blumenthal.

What's more, this consumer-mediated HIE creates a new business sector, according to Dr. Blumenthal. Managing health information may be a challenge for patients, but it opens the door for third parties to "steward and distribute…as directed," he wrote.

Reaching this type of data sharing will require three key steps, according to Dr. Blumenthal. First, the government needs to be more persistent about HIPAA's provisions regarding information sharing. Second, the industry needs to develop a certification or regulatory measures to ensure health data stewards can securely handle patient data. Finally, the industry needs to refine the technical elements of data stewards to access healthcare providers' electronic data repositories.

"All these steps are feasible. Several are already under way," Dr. Blumenthal wrote. "If we can accomplish them, we may be able to realize the full potential of the digital healthcare revolution."

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