A recent survey of six health information organizations (HIOs) in Pennsylvania highlights areas of operational progress and those that still need work, including harmonizing patient consent and creating a process to allow patients to dispute data included in their medical records.
The six HIOs that responded to the late 2014 survey conducted by the Pennsylvania eHealth Partnership Authority indicated their intent to connect to the authority’s statewide Pennsylvania Patient & Provider Network (P3N) in 2015; a seventh HIO —St. Luke’s University Health Network’s eVantageHealth —connected in 2014.
For the first time since the annual survey was begun in 2011, all responding HIOs report a function—discharge summaries—as currently operational.
All six indicated that they have a sustainability model in place, up from just over half in last year’s survey, but several expect further changes to their models. All six responding HIOs report that they have or intend to leverage federal grants to fund their HIOs. All but one leverage state grants, and all but one leverage private grants. Four of six leverage a combination of fees paid by participating payers, hospitals, and physician practices. The remaining two use only payer participation fees. Only two HIOs have developed processes to measure their impact, but neither is able to report measurable return on investment.
Respondents are moving toward use of both push and query across virtually all functions, except for clinical messaging. All HIOs now offer or plan to offer query for at least one function. This was not the case in past surveys.
Five of seven responding HIOs reported that they currently exchange or are planning to exchange information with federal-level entities such as the Veterans Administration and Social Security.
Two HIOs have adopted hybrid models for consent management, meaning that under some circumstances patients must opt in to the exchange of their data. All other HIOs have adopted opt-out models.
Four of six HIOs currently provide individuals with the ability to understand what individually identifiable information exists about them within the HIO. Three provide a mechanism for individuals to ask for access to their own records via the HIO in a simple and timely manner, and these same three can provide electronic copies of protected health information if requested. Three HIOs provide individuals with a way to understand how their individually identifiable information is collected, but none allow patients to make decisions regarding this collection. Four allow individuals to understand how their information is used or disclosed, but only one provides a mechanism for individuals to decide how their data is used.
Only two responding HIOs have a process in place to allow patients to dispute data included in their medical records, but most have mechanisms to identify and correct data errors that occur due to erroneous patient matching. Only three maintain indicators to signify that information has been corrected and record the date of revision. None of the responding HIOs can currently produce messages to those who have previously pulled records subsequently found to be in error to notify them of the issue and that it has been resolved.
