HITPC: Data portability examined

As evidence suggests a rise of demand for portability across systems, the Health IT Policy Committee requested that the Standards Committee explore the possibility of defining elements of a core clinical record that are easily extractable and consumable by EHRs to support data migration and patient portability use cases.

“There needs to be some type of common baseline for medical record continuity. It’s difficult because of the heterogeneity out there,” said Information Exchange Group chair Micky Tripathy, president and CEO, Massachusetts eHealth Collaborative, during the committee’s Nov. 6 meeting.

Through conversations with the Electric Health Record Association and the S&I Framework, Tripathy reported two use cases needing attention, one pertaining to data migration for providers looking to switch EHR systems and another regarding continuity of care for patients who are switching providers.

EHRA commented that building portability upon the construct on C-CDA would not work well. “But it was relevant to patient portability case,” he said.

Some policy committee members expressed concern about the difficulty in identifying common elements, especially before MU Stage 3.

“There are such large differences in these systems and data definitions, it only takes a single data element—which one system uses as unstructured and another uses as structured—that makes this process very difficult,” said committee member Paul Egerman, businessman/entrepreneur, adding that MU Stage 3 is too soon to develop such a standard.

In the 2014 EHR product certification, there already are data portability requirements, including the common MU dataset, answered Tripathy. “We’re already starting at a place with structure in it, what we’re asking for is the standards committee to pick that up and make it usable for the use cases.”

Terry Cullen, MD, director of informatics at the Veterans Health Administration, discussed matching problems and other barriers to interoperability at the VA. “It is a slow moving animal and will require a lot of work at both the vendor and provider level. Perhaps one small encapsulated use case you can push through to see what you can match would be useful.”

However, other members, like David Lansky, president and CEO of the Pacific Business Group on Health, urged the development of core elements as soon as possible. “I think it’s very important we keep to the Stage MU 3 timeline and get the core data set defined.”

The committee agreed to have the Standards Committee explore the matter further.

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