How Can a Standard CCD Help Communicate Information to Patients?
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The information included in the record focuses on the diagnosis and reason for referral rather than symptoms and treatment chronology. It may include information from only a single provider visit or may be more extensive to include data from multiple visits. The amount of information included varies by provider and patient.
In other words, there are 231 HIEs that are currently not making enough revenue to cover operating expenses. Many of these HIEs are able to continue operation due to HHS grants and because member healthcare organizations are willing to risk a short-term financial loss because they believe the HIE will gain widespread provider acceptance, which will eventually help them recoup early losses through several cost savings measures and future government reimbursement incentives (e.g., bundled payments, quality of care benchmarks). Local physician practices are slow to adopt EMR systems due to significant costs that can outpace Meaningful Use reimbursements and, some would argue, because they have no financial incentive to enthusiastically adopt a new healthcare system that moves away from the fee-for-service model they have successfully used for generations. From strictly a business sense, it’s logical for them to ask “What’s in it for me?” before investing hundreds of thousands of dollars on an EMR system just so they can connect with the local HIE. HIE directors must prove to the referring physician community that patients overwhelmingly want a system that securely exchanges their medical data, and that belonging to such a system will provide the physicians a return on their investment of an EMR system with external connectivity, HIE fees, and all the additional technology and staff required to make it functional. Through Meaningful Use and HHS, the government is also playing a major role in pushing all providers toward a modern, electronic medical system. However, time is of the essence for HIE sustainability and there are no government mandates that require participation in an HIE, regardless of the obvious benefits it has for patient care. Meaningful Use Stage 2 objectives may push eligible professionals to utilize an HIE, but those rules are not effective until 2014.
Health information exchanges confront this same obstacle, where even successful networks note the challenge of normalizing heterogeneous EHR data (Blumenthal D, 2010). Information exchange is consequently the exception rather than the norm. Recent federal initiatives, however, are beginning to dismantle these barriers.
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Grannis SJ, Biondich PG, Mamlin BWet al.How disease surveillance systems can serve as practical building blocks for a health information infrastructure: the Indiana experience. AMIA Annu Symp Proc. 2005:286–290
American Recovery and Reinvestment Act of 2009. Washington, DC: 111th Congress of the United States of America; 2009
Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010