Bundled Payments and Pay-for-Value Drive Need for Interoperability and Information Exchange

Atlanta, Georgia - Interoperability was one of the hottest topics at HIMSS15 due to its significant impact on what has been called the “Iron Triangle” of healthcare – access, cost and quality. Interoperability is central to health information exchange across multiple care settings, meaning everyone in the healthcare ecosystem has a stake in secure data sharing.

“There is an increasing body of evidence showing that care providers who are equipped with comprehensive patient information can deliver better quality care,” said Dr. Denise Hines, PMP, FHIMSS. Dr. Hines is executive director of the Georgia Health Information Network (GaHIN), the state HIE for Georgia, and a nationally known authority on health IT.

“Not only does timely access to patient information at the point of care improve the quality of care delivered, it also lowers costs by eliminating duplicate costs and services,” Dr. Hines continued. “Ensuring providers in rural and underserved areas have the same access to information as someone in a large healthcare network is a positive step to achieving technology equality, ensuring everyone receives quality care, regardless of location.”

The fact that a great deal of clinical information resides in electronic health records (EHRs) is promising, but those systems tend to create data siloes. The Office of the National Coordinator for Health Information Technology lists 2,620 certified EHR products or modules in its 2014 attestation database.

“The large number of disparate systems makes it extremely difficult to universally connect EHRs,” Dr. Hines explained. “That’s why Health Information Exchanges are attracting more participants; they offer a low-cost, high-impact way to securely share healthcare data.”

New payment models such as bundled payments and pay-for-value require coordination among multiple providers and are spurring the move to increased data sharing. In early January 2015, the Centers for Medicare and Medicaid Services announced that by 2016, 30 percent of Medicare payments need to be linked to payment reform models, with that number rising to 50 percent by 2018.

Almost simultaneously a report, “Connecting Health and Care for the Nation, A Shared Nationwide Interoperability Roadmap,” (PDF) was released calling for most providers to be able to use their systems to send, receive and use “a common set of electronic clinical information … at the nationwide level by the end of 2017.”

“The ability of HIEs, such as GaHIN, to facilitate care coordination and exchange patient information among hospitals, physicians and other providers will support these new mandates and encourage adoption and use of HIEs,” said Dr. Hines. “Statewide – and nationally – provider communication and collaboration not only helps to improve patient care, it also reduces potential medication and medical errors, streamlines workflow and decreases administrative costs. Physicians can spend more one-on-one time with patients instead of tracking down records.”

About Georgia Health Information Network

The Georgia Health Information Network (GaHIN) is a nonprofit organization dedicated to the use and exchange of electronic health information to foster a healthier Georgia, improve patient-centered healthcare, increase efficiency and promote the health status of the entire state population. GaHIN’s purpose is to close the patient information gap across all care settings by electronically connecting disparate systems and data sources to support improved quality of care, better health outcomes and reductions in cost. www.gahin.org.

Media Contact:

Lynn Hood, GaHIN, lhood@gahin.com, 678-427-5040