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Medicare’s push for portability of electronic health records: easier said than done

Summary

Bipartisan support for MyHealthEData won’t be enough to pry health records from outdated systems

Newswire: March 12, 2018.

Dateline: Washington.

In light of the Medicare administrator’s call for greater openness and patient access to electronic health records, experts and observers are weighing in on how tough it will be to implement one of the rare efforts of bipartisan agreement in the government.

Vox.com’s Sara Kliff, who last year published an analysis explaining why fax machines remain so useful to the healthcare industry, noted that electronic health record portability is often difficult because there is a big financial disincentive to make it portable.

“We don’t expect Amazon and Walmart to share background on their customers, but we do expect competing hospital systems to do so,” David Blumenthal told Vox. He coordinated health policy in the Obama administration from 2011 to 2013. “Those institutions consider that data proprietary and an important business asset. We should never have expected it to occur naturally, that these organizations would readily adopt information exchange.”

There have been instances, though rare, of competing healthcare organizations working together within the same market to share and liberalize patient access to data. More likely, a healthcare organization participates in a larger data sharing network with peer-sized organizations located elsewhere in the nation.

Seema Verma, the Medicare administrator, last week announced a new initiative called MyHealthEData. In the statement announcing the initiative, the Centers for Medicare and Medicaid Services said MyHealthEData “will help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice. This effort will approach the issue of healthcare data from the patient’s perspective.”

Further, the centers “will be re-examining its expectations for Medicare Advantage plans and qualified health plans (QHPs) offered through the federally facilitated exchanges, and calling on all health insurers to release their data.” Most of this will be accomplished through executive order or action. Last year the Trump administration issued an executive order “to Promote Healthcare Choice and Competition Across the United States” aligned with these goals.

But that is easier said than done. The Obama administration made health record portability a priority, too, including it in the American Recovery and Reinvestment Act of 2009, the so-called stimulus bill responding to the global crisis that had battered much of the nation’s economy. Officials from that administration told Vox that they felt their program did not go far enough. Doctors would get bonuses for adopting electronic records management systems, but there was no financial incentive or penalty for sharing or not sharing it.

If there’s no financial incentive for healthcare providers to share data, there’s even less of one for doctors to become more involved with electronic health records. Studies have shown doctors spending more time with records than patients, contributing to burnout and job dissatisfaction. MyHealthEData may be an initiative where lawmakers find common ground, but it has a long ways to go before health records are truly electronic and portable, and not shared by fax machine or CD-ROM.

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