The appeal of the opt-out model
Were Tuesday’s election results a mandate for change? A repudiation of change? As we all try to figure out what the new political reality will mean for healthcare IT—and when—the HIMSS Virtual Conference earlier this week highlighted some state and federal HIE accomplishments, and some of the plumbing that ensures a steady flow of information.
Increased provider participation is a priority for health information exchanges because more providers can mean more data and thus more HIE value for all parties. As Anna Daly, MSN, RN, HIE coordinator for ICA, in Nashville, Tenn., said in her HIMSS Virtual Conference presentation this week, “You have to give them a reason to come in and a reason to come back.”
How will data enter the stream? “Discussions around the HIE consent model are far from settled,” and ONC’s Tiger Team and others are looking at privacy/security frameworks to use as models, said Daly, a member of the HIMSS Privacy and Security Steering Committee, who made the case for the opt-out consent model.
In an opt-out model, PHI (protected health information) is collected unless a patient opts out. Some models allow patients to opt out of data disclosure only, or exclude particular PHI or specific data elements, or limit disclosure to certain providers or for specific purposes.
Interestingly, when given the option of opting out, patients are generally willing to stay in, Daly said, if they trust the framework to keep their information private and secure. This is a big “if,” and it takes strong IT security mechanisms, policies and governance to bolster that trust, she said.
“One of the key things we have done was [build a strong] organization. We worked with [integrated delivery networks] and regional health organizations, starting with workgroups and committees, [and] starting with strong governance.” Equal participation is also important: “Make sure you have equal voices from all participants so all voices are heard, including community voices,” she said. “We try to have at least one consumer representative, so we have some outside representation other than the individual healthcare participants.”
“Finding the right balance point between patient data and consent is more a business and policy problem than a technical challenge,” although the IT issues are far from trivial, she said. “However, we can manage an opt-out model, nationally… it will require strong commitment from the healthcare community and sound guidance from national and local leaders.”
The same can be said of HIEs and other initiatives, of course, as we watch how the election shakes out health IT priorities.
Mary Stevens, editor
mstevens@trimedmedia.com
P.S.: Don’t miss the CMIO Summit, November 19 in Atlanta. Click here for details.
Increased provider participation is a priority for health information exchanges because more providers can mean more data and thus more HIE value for all parties. As Anna Daly, MSN, RN, HIE coordinator for ICA, in Nashville, Tenn., said in her HIMSS Virtual Conference presentation this week, “You have to give them a reason to come in and a reason to come back.”
How will data enter the stream? “Discussions around the HIE consent model are far from settled,” and ONC’s Tiger Team and others are looking at privacy/security frameworks to use as models, said Daly, a member of the HIMSS Privacy and Security Steering Committee, who made the case for the opt-out consent model.
In an opt-out model, PHI (protected health information) is collected unless a patient opts out. Some models allow patients to opt out of data disclosure only, or exclude particular PHI or specific data elements, or limit disclosure to certain providers or for specific purposes.
Interestingly, when given the option of opting out, patients are generally willing to stay in, Daly said, if they trust the framework to keep their information private and secure. This is a big “if,” and it takes strong IT security mechanisms, policies and governance to bolster that trust, she said.
“One of the key things we have done was [build a strong] organization. We worked with [integrated delivery networks] and regional health organizations, starting with workgroups and committees, [and] starting with strong governance.” Equal participation is also important: “Make sure you have equal voices from all participants so all voices are heard, including community voices,” she said. “We try to have at least one consumer representative, so we have some outside representation other than the individual healthcare participants.”
“Finding the right balance point between patient data and consent is more a business and policy problem than a technical challenge,” although the IT issues are far from trivial, she said. “However, we can manage an opt-out model, nationally… it will require strong commitment from the healthcare community and sound guidance from national and local leaders.”
The same can be said of HIEs and other initiatives, of course, as we watch how the election shakes out health IT priorities.
Mary Stevens, editor
mstevens@trimedmedia.com
P.S.: Don’t miss the CMIO Summit, November 19 in Atlanta. Click here for details.