Verizon, AT&T and Microsoft Vie For Piece of Growing Market for Health Data Exchange
Verizon has joined AT&T and Microsoft in offering large-scale web platforms for health information exchange (HIE), hoping to get a piece of the $564 million that the federal government is funneling to HIEs through the states. But it's unclear whether these HIEs will be as useful in patient care as the technology vendors claim.
The Verizon Health Information Exchange will collect patient data from a variety of information systems and translate it into a standardized format that can be securely accessed over the web. Participating providers will be able to request information about a patient's medical history across regions, states, and the U.S. The fees that doctors and hospitals pay will be calibrated to the amount of data they view. The Verizon HIE complies with HIPAA security standards and also uses the same data-sharing standards as the National Health Information Network (NHIN). MedVirginia, a pioneering HIE in Richmond, Va., that has participated in NHIN tests, will be among Verizon's first customers.
The AT&T Healthcare Community Online employs a similar data repository that standardizes data from a variety of sources, including prescriptions, lab results, diagnoses, and medical histories. AT&T also offers Microsoft's HealthVault personal health record to patients. According to AT&T, "This secure solution efficiently interconnects primary care physicians, specialty care providers, hospitals, patients and others involved in an individual's healthcare to make health information readily accessible with an on-demand cloud-based collaboration portal."
Are we speaking of the "cloud"? Then we have to mention Microsoft, which featured cloud computing heavily at its recent Worldwide Partner conference. Microsoft, which has long had a presence in health IT, has a web-based HIE called Amalga that combines the central repository approach with a federated, or peer-to-peer, approach to computer networking. A few big healthcare organizations, including New York-Presbyterian Hospital, Mayo Clinic, Novant Healthcare, and Johns Hopkins Hospital, have adopted Amalga as their preferred method of sharing data with their doctors and patients. But others are skeptical.
Rick Schooler, chief information officer of Orlando Health, a seven-hospital system in Orlando, Fla., told me that Amalga is "an advanced clinical data repository that accepts a lot of information from a lot of different places." But to create true clinical integration between hospitals and physician practices, he notes, you need a way to send data back and forth between their disparate EHRs.
A standardized electronic document known as the "continuity of care document," or CCD, can theoretically be used to exchange key patient data among different EHRs. The CCD has received the approval of standards development organizations as well as the Department of Health and Human Services. But the ability of systems to extract the necessary data and transmit a CCD from one EHR to another is still in an early stage.
Microsoft claims that it can send patient data from its cloud-based HIE and from HealthVault into some EHRs. But HealthVault still doesn't have interoperability even with the EHR of the Mayo Clinic, one of its biggest boosters. Verizon and AT&T don't claim that doctors can download HIE data into their EHRs.
What this means is that if a physician wants to view data in one of these HIEs, he has to leave his EHR and go on the HIE website to see if any information on his patient is there. If anything relevant exists, he'd have to print out the screen and then have the information entered into his electronic record. (The same would be true for doctors who don't have EHRs, except that they'd just stick the printout in a paper chart.) None of this is likely to happen on a wide scale, because it would create difficult and burdensome dual workflows for doctors.
Clearly, the healthcare system has a long way to go toward health information exchange that is truly useful to physicians. But the technology giants may help accelerate the progress that is slowly being made.
Image supplied courtesy of nodomain1 at flickr. Related: