Viewpoint: Challenges to Health Data Sharing Must Be Addressed

Overcoming barriers to health information exchange is critical to improving the U.S. health care system, according to a viewpoint published in the Journal of the American Medical Association, CMIO reports.

The viewpoint was written by Julia Adler Milstein of the University of Michigan-Ann Arbor and Ashish Jha of the Harvard School of Public Health.

The authors wrote, "The vision of complete patient information available across care delivery settings is compelling and central to a high-functioning health care system," but "the vision is deceptively simple: there are enormous challenges to enabling clinical data to flow across organizations."

Challenges to Sharing Data

The authors outlined five major barriers hindering the widespread exchange of electronic health data, which are:

  • Data privacy and security concerns;
  • Physicians' and hospitals' concerns that greater data sharing might spur patients to seek care at rival institutions;
  • Low rates of physicians demanding electronic access to patient data or using such information when it is available;
  • The use of point-to-point exchange tools, which could hinder the use of interoperability tools that allow for more structured data exchange; and
  • The fact that some physicians and health care organizations are excluded from the meaningful use program.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.


To achieve more robust health data exchange, the authors recommended that policymakers:

  • Enact policies that encourage health care providers who are excluded from the meaningful use program to adopt electronic health records and participate in health data exchange;
  • Establish incentives for all health care providers to make certain types of health data available for exchange in a structured format; and
  • Provide more details and guidance on the consequences of health data breaches (Byers, CMIO, 4/25).
Keith Boone
On point #2: Greater sharing might spur patients to seek care elsewhere: See my post on "What Are you afraid of" (click on the link above)
Merle Bushkin
There's a simple way to make patient records available to providers. Organize them around the patient. Our patent-pending MedKaz personal health record system does just that (see It stores a patient’s records from ALL their providers in ALL formats, paper and electronic, on a distinctive flash drive the patient owns and controls (NOT on remote servers). It requires NO networks. The patient simply hands it to their provider who accesses its contents as needed; updates it after each visit (we pay them to do so). It's free to providers, easy to use, doesn't disrupt their workflow, increases their income, and saves them time. They can avoid mistakes and unnecessary tests, and coordinate their patient's care with other docs. The patient also benefits. They know their records are secure yet available whenever needed, at home or away, in network or out. They can read and correct them, and participate in their care decisions. It’s easy to use and inexpensive.
Kim Slocum
The problems associated with health information exchange are not primarily technical--they're cultural. Provider groups don't share data mainly because they choose not to do so for competitive reasons. The solution to the health information exchange problem therefore lies far more in breaking down those barriers rather than in looking for a better technology mouse-trap.

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