Q&A: Standards are key to wider information exchange, HIE exec says

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System integration via interoperability is essential to achieve outcomes required for meaningful use, Todd Rowland, executive director of HealthLINC, a health information exchange (HIE) formed by Bloomington Hospital and the physician community in Southern Indiana told CMIO.

Rowland described the integration efforts under way at HealthLINC, a community-based organization that leads the HIE effort on behalf of healthcare stakeholders in Monroe, Orange and surrounding counties in South Central Indiana to support a fully integrated electronic healthcare delivery system.

CMIO: With regard to EMRs and point-of-care information exchange, what are the biggest barriers to systems interoperability?
Rowland: The most intense barrier to interoperability is the perceived lack of business model for vendors to share data between different systems. I am hopeful that the regulatory requirements for use of data standards and demonstrating interoperability to achieve CMS' incentives will reduce this barrier.

CMIO: What is HealthLINC doing to ensure interoperability of clinical systems?
Rowland: Interoperability is being addressed at the HIE and health-system level in our community. At this hospital level, custom software development projects are achieved using data standards like CCD [Continuity of Care Document] and RxNorm. The hospital system also strongly encourages use of data standards by its health IT enterprise vendors.

At the HIE level, the data standards including CCD and LOINC for labs are essential. HealthLINC has already demonstrated the value of LOINC-mapped labs during a LIS [lab information system] change from one of the healthcare systems.

CMIO: Can EMRs succeed in the absence of national standards for system interoperability?
Rowland: The EMR marketplace has demonstrated that interoperability cannot be achieved without data standards during the past two decades. The lack of interoperability has contributed to [EMRs’] limited adoption and use by physicians, who are very sensitive to the limited re-use of information when interoperability is not present.

CMIO: Do you think systems integration / interoperability issues will affect healthcare providers’ ability to comply with meaningful use guidelines and deadlines?
Rowland: It is clear to me that integration via interoperability is essential to achieve outcomes required for meaningful use. The Office of the National Coordinator for Health IT has established a governance structure, including the HIT Policy and Standards Committee that reinforces interoperability as key strategy for clinicians and health IT vendors.