MITRE's hData Effort Promotes Sharing Electronic Health RecordsFebruary 2011
Topics: Health Services Administration, Collaborative Computing, Health Innovation
Many doctors and hospitals use electronic health records (EHRs) to collect and store their patients' medical information. Even as EHRs continue to gain popularity, however, barriers to sharing these records among clinicians still limit their usefulness. For instance, the lack of an overall view of the patient's health history can lead to problems ranging from overlaps in prescription medication to unnecessary repeated tests. MITRE is working with the health IT community to change the status quo.
"We envision a future in which the entire relevant medical history of patients can be available to their care teams," says Rob Jensen, executive director of MITRE's Center for Transforming Health (CTH).
One of the key hurdles to sharing clinical information is the complexity of the current data formats used by many EHR systems. To help promote EHR adoption and data sharing, MITRE is currently contributing to the development of a new technology standard. MITRE's prototype, known as hData, makes it easier to develop, exchange, and validate electronic medical records (see "A Simpler Technology Standard").
MITRE has worked closely with software developers, standards development organizations, academics, and others in the medical community to make sure hData can work with a broad range of existing EHR technologies. "Our systems engineers understand technology in the broader sense and have entered into discussions with health IT experts so that we can incorporate their input as we develop the standard," says Joy Keeler Tobin, who heads the health IT initiative as CTH program manager. "If we were to develop the standard without their input, it wouldn't work. And because we serve in an FFRDC role, the health IT community is willing to cooperate with us, even sharing their proprietary data formats."
Before hData can become a federally endorsed standard, it will need to go through a process that leads to being recognized by an ANSI-accredited standards development organization. To meet this objective, MITRE is working as a member within Health Level 7 International (HL7), one of the largest health IT standards organizations. As a veteran of standards-setting bodies across several industries, we are ensuring hData can be adopted as a peer-reviewed standard by the medical community.
To bolster its case, a MITRE team in 2010 worked on a pilot to prove how hData could be used to successfully exchange lab orders, test results, and other clinical information. This is an important process for maturing hData. Moving forward on the development of interoperable medical records will also help healthcare providers meet federally mandated goals for exchanging health data electronically.
Performed in conjunction with Emdeon, which develops healthcare payment cycle management solutions, the pilot demonstrated how such an exchange can take place in a secure, cost-effective manner. By using hData in conjunction with Emdeon's solution for displaying and organizing lab reports, radiology reports, and transcriptions, MITRE and Emdeon successfully exchanged test patient information through a Web portal.
"hData provides a way for the industry to map clinical data from any electronic health record system," says Miriam Paramore, senior vice president of clinical and government services for Emdeon. "Because providers use disparate healthcare IT technology solutions, they need an easy method of mapping and exchanging clinical data between and among systems."
"Our work on the pilot lays the foundation for more efficient healthcare information exchange," adds Keeler Tobin. "Further analysis will provide us with important insights on standards in the months to come."
A Unified View
"Ultimately, we hope hData will significantly lower the barrier to creating interoperable clinical systems," says Gerald Beuchelt, a MITRE lead software systems engineer who works on the project.
Beuchelt's enthusiasm is shared by Andy Gregorowicz, also a lead software systems engineer who spearheaded the initial hData effort. "The idea is that it shouldn't matter which EHR system your primary care doctor uses," he says. "If you then go to see a specialist, you should be able to have your basic health information exchanged between the doctors. This isn't usually the case today."
By providing a comprehensive view, hData will offer a variety of benefits. For example, hData could potentially lower healthcare costs by eliminating duplicate tests or speeding up the communications between clinicians, which is likely to result in more responsive patient care. A simpler approach will offer medical benefits as well. "It will improve care because your providers will have a list of all the medications you're taking, which should reduce the risk of them prescribing conflicting drugs," says Gregorowicz. "All the clinicians treating you will have a unified picture."
Healthcare providers anticipate other efficiencies as well. "With improved patient access to EHRs, people can check the status of their labs and get other information without having to go through their doctors all the time," says Beuchelt. "With hData, doctors can even subscribe to medical records from different systems and medical monitoring devices and be alerted to changing information, if the patient allows it."
hData could also stimulate the development of personal health mobile apps, making it easier for patients to take an active role in their healthcare. "We believe that hData's simple design will shine on mobile devices. On a smart phone, you don't have the same resources as a desktop computer to deal with heavyweight data formats," says Jensen.
For more information on hData, go to www.projecthdata.org.
by Maria S. Lee