Mastering Data Management

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We can all learn data sharing lessons from around the globe

With increasing amounts of government funding for data sharing, many healthcare leaders are rightfully looking to other nations who have successfully traversed the HIE and data sharing path. But each nation’s priorities and plans vary widely.

In the past couple years, the US has encouraged adoption of EHRs, advances in e-prescribing and improved data sharing, with $46-48 billion earmarked for incentive funding through the American Recovery and Reinvestment Act (ARRA). The net expenditure is estimated to be $16-19 billion as a result of efficiencies.

Established by ARRA, the Health Information Technology (HIT) Policy and HIT Standards Committees are fostering transparent discussions to develop policy and standards supporting HIT adoption. While past activities have largely focused on standards, now policies are being established for areas such as privacy and security.

The US is learning firsthand how time-consuming and difficult it is to establish policy, payment and HIT adoption in parallel pathways.

Given the ARRA timelines (which are particularly aggressive since they are meant to stimulate the US economy), mistakes will undoubtedly be made in the adoption and execution of regulations and policy. The open discussion frequently notes the need to consider unintended consequences.

Canada has proven that interoperability succeeds when certain elements are in place, including: common architecture and standards; accurate and immediate identification of patients and providers; and common information management processes. Such commonalities and planning can leverage existing legacy systems while overcoming differences in how data is recorded and stored.  Since 2004 CA$1.6 billion has been spent to support these priorities.

Countries with sparsely populated areas like Australia, Canada and the US benefit tremendously if broadband adoption and telehealth are incorporated into their master plan for electronic records and data sharing.

Other countries advancing electronic record adoption and data sharing, such as Mexico, Singapore and Australia, do not have the artificial timelines that the US is encountering, thus their pathways can be more deliberate and thoughtful.  However, delays ultimately increase expenditures as healthcare costs continue to spiral.

Further, delays could also hinder future public health threats. The past decade has seen major disease outbreaks bordering on pandemics with the likes of SARS and H1N1.Critical to diagnosing these trends is the ability to track and share information in rural and metropolitan areas within a country, as well as globally.  And, this information sharing must be real-time, not delayed by weeks or months.

Broadband deployment and telehealth play vital roles in data sharing, particularly in countries like Australia, Canada and the United States with vast geographies. The US ARRA recognized this importance by allocating more than $7 billion for broadband funding.

Telehealth is particularly effective in addressing mental health, dermatology, radiology and specialized monitoring through remote cameras and specialized devices. Patients receiving care through telehealth are seen in rural or remote areas without the time delays or economic hardships of extensive travel.  Specialized practitioners can be concentrated in select, highly populated geographies, yet their services are available for the remote, rural areas.

In 2009, the Louisiana Rural Health Information Exchange quickly quantified their benefits through decreased transportation costs, reduced workplace absenteeism and quicker healthcare services that ultimately lower the cost to the state Medicaid program.  LARHIX’s CIO, Jamie Welch, covered the results in detail in a blog post.

Canada has seen telehealth adoption supporting radiology, mental health, dermatology, and specialty medicine. As a pioneer in telehealth, Australia has perhaps seen the most success with mental health and dermatology.

Not lost in all the discussion of telehealth should be the higher patient satisfaction as a result of less stress, less travel and support systems for care.

Regardless, we can all learn data sharing lessons from our colleagues around the globe who have been already been through some of the challenges.