Building a Framework for Interoperability

While barrier-free health information exchange presents promise, hacking and potential HIPAA violations make connected care a risky business. The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) has testified before Congress to discuss topics such as health information technology (HIT) security, the personal care services program, and Medicare and Medicaid program integrity concerns.

Beyond the dangers of free-flowing information sharing is the task of connecting unconnected networks. What it takes to form a standards-based web of connected networks is under the watchful eye of Mariann Yeager, who heads a nationwide IT initiative called The Sequoia Project, through which Carequality exists. “Use of health information technology has really exploded,” Yeager says. “Although it may not be as evident for some care providers, it is unprecedented and it’s revolutionizing health care. Every region is different. There’s been a natural progression—connected health information and the ability to share information started with larger health systems and provider groups. It is starting to enter these other care settings such as homecare.” For homecare, we have an opportunity to support care plan approaches that are tailored to the homecare, hospice and post-acute care settings, Yeager says. Carequality requires using a common set of standards, agreeing to privacy and security requirements, and agreeing to when information can be shared, by whom and for what purpose, in a coordinated way. For care providers feeling the pressure to adopt technology programs, and even dealing with vendors of HIT services, Yeager recommends looking for ONC Certification from the Office of the National Coordinator for Health Information Technology, for example. The ONC Health IT Certification Program highlights HIT products for its encouraged and required use under federal, state and private programs. The requirements changed late last year. Yeager also recommends exploring your regional or state health exchange network for leads; exploring EHR certification programs (vendors with up-to-date certification may offer services to care settings such as homecare and hospice); exploring the strong players in your region; and checking to see if the health information vendor is part of an interoperability initiative such as Carequality. More than half of all health care providers in the United States are connected electronically through the Carequality Interoperability Framework, according to The Sequoia Project. Members of the Carequality collaboration include physicians, consumers, government agencies, payers, acute care, long-term care, hospice and homecare, pharmacy and others. Read the full February cover series here.