Data sharing, interoperability improve patient care and outcomes

According to Crystal Baum, director of data sharing at the Federal Office of Federal Health Records Modernization, the value of patients’ medical records and electronic health records increases with the sharing or interoperability of information across multiple health networks.

Shared solutions, tools and activities are needed to ensure meaningful data sharing between patients and providers, Baum said.

The Federal Electronic Health Record Modernization, or FEHRM, office along with the Department of Defense, Department of Veterans Affairs, Department of Homeland Security Coast Guard, Department of Commerce National Oceanic and Atmospheric Administration and other federal partners are implementing the only one. federal shared EHR together. DOD refers to the federal EHR as MHS GENESIS, which enables a digital version of a patient’s medical record across the continuum of care for all 9.5 million DOD service members, retirees and family members. DOD completed the worldwide deployment of MHS GENESIS on March 9, 2024.

“FEHRM digitizes patient records and implements capabilities to increase efficiency, improve data quality, and allow secure access and sharing of health information in a complete electronic medical record from the time you join the military through care your as a veteran to improve patient care. and clinical decision-making regardless of where care is provided,” said Baum.

According to FEHRM’s website, the advantages of a unified EHR for patients and providers include:

• Spend less time repeating your health history to providers, undergoing duplicate tests and managing hard-copy health records

Facilitating access to health records for providers, even after you leave the military

• By having productive conversations as a provider, you have a comprehensive view of your health data before your appointment
• Enabling more informed decisions because providers have access to more relevant data
• Experience seamless care through collaborative health information sharing, which enables providers to easily share and access health information to increase quality of care and satisfaction

The federal EHR provides a toolbox of capabilities to enable positive patient outcomes, advances interoperability, and distills data now available through the federal EHR.

Data interoperability

The shared HIE links the federal EHR information with the participating provider organizations’ EHR information that has been consented to by the patient. These range from single-physician offices to multi-hospital systems outside the federal health care system. FEHRM expanded the joint HIE in August 2023 to include CareQuality, a framework that enables the interoperability of health data between networks.

The action expanded the percentage of US hospitals affiliated with shared HIEs from 75% to more than 90%; greatly expanding the access of clinicians, nurses and administrators to an expanded set of external patient health data.

Vaccine Immunization Records

Linking to state immunization registries is one way FEHRM is advancing interoperability, Baum said.

DOD and VA signed agreements to participate in data sharing with state immunization information systems, Baum said. Access to these registries provides consolidated immunization histories within the federal EHR and combines data for better population health outcomes. The Centers for Disease Control and Prevention’s Immunization Gateway provides a standardized policy infrastructure through a single integration hub and message routing service, she noted.

Through CDC’s Immunization Gateway, DOD is currently sharing immunization data with five states and has plans to add four more states in the future. “We can bring that data as well as report that data back to the state,” Baum said. “Having that data at your fingertips and not having to vaccinate someone twice optimizes care,” Baum said.

TEFCA and the Mutual Agreement

The Trusted Exchange Framework and Common Agreement, mandated by the 21st Century Cures Act, will outline a policy and technical approach to enable the nationwide exchange of electronic health information across various known health information networks. also as HIN.

For patients, providers, developers and HINs, TEFCA will “provide a single, statewide connectivity platform that can support the secure electronic exchange of health information,” according to its website. “Once finalized, TEFCA will give patients, healthcare providers, payers, HINs, health IT developers and other stakeholders access to data when and where they need it to better support care to the patient.

HINs are the central connection points within the networks that would be responsible for saving all queries or responses and messages.

“At some point, FEHRM will have to decide which HIN to join to participate in TEFCA,” Baum said, adding that the office will wait until TEFCA “hits a critical mass for it to be extremely useful”, by FEHRM. point of view.

Hassle-free exchange

To simplify the federal EHR end-user experience, FEHRM, DOD, and VA focused on seamless exchange—an improvement that retrieves, deduplicates, and synchronizes data from multiple sources, ensuring ease of use and easy access to updated information. comprehensive.

The seamless exchange is also part of improved data sharing and makes interoperability more efficient, Baum said.

In 2022, the VA piloted the seamless exchange at a clinic affiliated with the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, Washington. The federal EHR was deployed there in March 2022.

The pilot looked at problems, allergies, procedures, immunizations, and medications in the federal EHR. “Initial metrics showed reduction of duplicate data in each of these fields by at least 99%,” said Baum.

The VA is planning to expand that pilot to other Walla Walla medical center-affiliated clinics, “and then, eventually, to all of their locations because of the success of that pilot,” Baum said. “Hopefully, based on that success, DOD will decide to implement a continuous broad exchange venture as well,” she suggested.

“The federal EHR has the ability to look at a service member and their family’s transition of care between the public and private sector and provide recommendations to proactively manage care gaps in patient care to improve patient outcomes,” Baum said. . “A comprehensive view of a patient’s health records is within the federal EHR—everything from a recent appointment at a nearby clinic, an immunization given at the local pharmacy, or an emergency room visit in another state. “