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• Have a notifi cation procedure in place in case a breach occurs; and

• Follow the HIPAA confi dentiality requirements, and limit the use and disclosure of PHI.

Business associates will most likely need to update their agree- ments with covered entities – as well as with subcontractors – to comply with the Omnibus Rule by Sept. 23, 2013 (Sept. 22, 2014, for “grandfathered” business associates).

Robyn Leone, director of public policy and government initiatives, e-MDs

EHR vendors should collaborate with HIEs Remember playing “telephone” and the funny, garbled mes- sages that emerged at the end of the communication chain? Unfortunately, sending and receiving healthcare data can have the same outcome. HIEs are a foundational element for the success of many

health reform and HITECH Act initiatives. T e variability and complexity of healthcare data off ers unique challenges in exchange. For example, code sets for lab results have a high degree of variability; during the exchange process that variability poses problems when attempting to populate an EHR. Unless all data shared by HIEs is “normalized” and mapped to standardized medical terminology, such as SNOMED-CT, and transcribed notes and other free text are converted into structured text, these problems will continue. Amped-up interoperability requirements under Stage 2 of

meaningful use should fuel quick action. As early as Oct. 1, 2013, hospitals must have the ability to send discharge summaries to a patient’s primary care provider. T is can be achieved through an HIE that can directly populate their EHRs with report data and test results. Eligible professionals will be subject to the same requirements starting Jan. 1, 2014, and will have the entire cal- endar year of 2014 to upgrade their EHR technology and adjust workfl ows to comply with the Stage 2 regulations. To achieve HIE success, EHR vendors should collaborate with HIE connectivity vendors and HIEs to develop turnkey interfaces that enable seamless interoperability, which allows physicians and other healthcare providers to have access to the most complete patient data. e-MDs is working with the Biparti- san Policy Center, which published a report that identifi es what’s needed to address some of these problems. T e report can be accessed at BPC’s website,

John Tempesco, ICA Informatics

HIE: 2013 trends and opportunities With time, the concept of the HIE as a noun has gradually

morphed into a verb. T e organizational construct concerned with policies and procedures has become an actionable reality. Today, HIEs are literal networks across which patient data is ac- tively transmitted securely to healthcare professionals in disparate geographic locations. T e corporate structure – whether inte- grated delivery network (IDN), accountable care organization (ACO) or formally structured health information organization (HIO) – matters less than the value off ered by data exchange. T is year will see HIEs continue to grow for two important

reasons: interoperability standards and value toward sustainability. Interoperability standards: Nationally adopted interoper- ability standards now have been incorporated by HIT vendors to facilitate the seamless exchange of patient data, irrespective of an organization’s specifi c EHR system. T e Direct Project, for example, which enables the transmission of encrypted health information over the Internet, also makes it possible for physi- cians to participate in HIE even without an EHR. Value proposition: Now that enough clinical information

systems are collecting data, there is sustainable value in HIE the verb – from both patient care and operational standpoints. In addition to creating effi ciencies in clinical workfl ow, HIE enables organizations to adapt more easily to emerging value- based reimbursement models. Today’s trends focus on making current processes more ef-

fi cient, and all of the elements are in place for an industry-wide tipping point. We are just now getting a glimmer of where the trends of 2013 are headed: toward data analytics. T e emergence of HIE data captured in a way for analytics and decision support to be layered on top will not just improve care, but completely transform it.

Gary Hamilton, founder and president, InteliChart

Three key steps to improve HIEs Exchanging relevant healthcare data is becoming increasingly

important to care coordination and quality improvement eff orts. T ese three key steps can help healthcare organizations improve the usefulness of HIEs for providers: 1. Acquire meaningful data. While technology has made obtaining patient information easier, delivering informa- tion relevant to providers still poses a challenge. EHRs often require providers to pore over large amounts of data to glean the most important clinical information, which is not an effi cient use of valuable time or resources. To make HIEs more eff ective, fi ltering mechanisms can be leveraged to pull the most meaningful information from an EHR, enabling providers to have the most up-to-date and salient clinical and demographic information available during a patient visit.


2. Standardize data terminology. T ere are multiple ways 7

April 2013

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