Mastering Data Management

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Through all the debate at eHealth, the constant theme was focusing on the patient.

The National Forum on Health Information Exchange was hosted by eHealth Initiative last week in DC, with 400+ vendors and attendees from local, state and regional data exchange organizations. To say they had an action-packed, informative agenda would be an understatement.

Several panelists, including Farzad Mostashari, Deputy Director at ONC, talked about the need for core services at the state level to address patient registries and provider registries. Some saw this need as key infrastructure that is simply essential to facilitate data exchange, while other panelists saw these core services as an avenue to sustainability.

Dr. Mostashari and other speakers also talked about the concept of shared registries to reduce cost and improve care. Patients don't stop at the state line just because ONC has awarded monies to each state-designated entity to advance exchange! Patients seek care across regional boundaries because their health plans, referral patterns and convenience do not respect the artificial state boundaries.

While inter-state data exchange is more complex, the planning must start now to it can be easier in the future. Federal privacy groups are addressing some of the complexity so guidance will be forthcoming.

Dr. Mostashari also reminded the group that in the context of Meaningful Use, exchange is more than just the one core measure that requires one test of exchange to meet the MU requirements.

Exchange also includes e-prescribing, giving patients access to their information, medication reconciliation and summaries of care for referrals. Initiate clients would certainly agree and were early adopters of this broad vision and understanding the value of data exchange.

My key takeaways from the panelists were:

• Don't build more silos of data by thinking NHIN direct is the solution to data exchange; rather it is an interim step on the road to robust data exchange
• Start local by designing the core infrastructure, including patient and provider registries for data exchange, but think bigger for the future
• Plan with your "neighbors" and break down the barriers of state line through shared registries and active dialogue about differing privacy and consent regulations

And most importantly: remember, this is about the patient!