Most of the time, when we discuss obstacles to interoperability, we focus on the varied technical issues and expense involved in data sharing between hospitals and doctors. And without a doubt, there are formidable technical challenges ahead — as well as financial ones – on the road to full-on, fluid, national data exchange between providers.
But those aren’t the only obstacles to widespread interoperability, according to one health IT leader. There’s another issue lurking in the background which is also slowing the adoption of HIEs and other data-sharing plans, according to HIMSS head H. Stephen Lieber, who recently spoke to MedCity News. According to Lieber, the idea that providers (not patients) own clinical data is one of the biggest barriers standing in the way of broad interoperability.
“There is still some fine-tuning needed around how technology is adopted, but fundamentally it’s not a technology barrier. It’s a cultural barrier and it’s also a lack of a compelling case,” Lieber told MedCity News.
In Lieber’s experience, few institutions actually admit that they believe they own the data. But the truth is that they want to hold on to their data for competitive reasons, he told MedCity News.
What’s more, there’s actually a business case for not sharing data. After all, if a doctor or hospital has no data on a patient, they end up retesting and re-doing things — and get paid for it, Lieber notes.
Over time, however, hospitals and doctors will eventually be pushed hard in the direction of interoperability by changes in reimbursement, Lieber said. “Work is already being done in Washington to redesign reimbursement. Once Medicare heads down that path, commercial insurers will follow,” Lieber told the publication.
Lieber’s comments make a great deal of sense, and what’s more, focus on an aspect of interoperability which is seldom discussed. If hospitals and doctors still cling to a culture in which they own the clinical data, it’s most definitely going to make the task of building out HIEs more difficult. Let’s see if CMS actually comes up with a reimbursement structure that directly rewards data sharing; if it does, then I imagine you will see real change.