JAN 31, 2013 5:22pm ET

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Cerner to Feds: Mandate ‘Directed Query’ Messages and Fix Patient ID Problem

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Testifying before the HIT Policy and Standards Committees on Jan. 29, Cerner Corp. CEO Neal Patterson called for expanded use of secure messaging technology and clear patient identifiers, saying existing ways to identify patients are not adequate.

He applauded the government for requiring electronic health records to support “directed push” capability--which is secure messaging using Direct Project protocols between providers--under Stage 2 of the meaningful use program. Patterson, in a joint committee hearing on health information exchange issues, then went a step further. He urged adoption in subsequent stages of “directed query” so any patient could electronically authorize release of information to a current provider regardless of where the information presently lies.

“The process should be simple, fast and universally available,” Patterson said. “It should work across all EHRs, regardless of vendor. We believe that directed push and directed query are necessary steps forward for true data liquidity.”

However, these capabilities do not guarantee safe and accurate flow of data and Patterson further called for a resolution to the issue of a patient identifier.

“As the volume of data interchange increases, we cannot continue to rely on statistical matches based on a highly constrained set of data elements,” he warned. “We need to set aside the admittedly tough politics of this issue and do what is right for health care consumers. Cerner is committed to exploring an industry-led approach to the voluntary use of patient identifiers based on existing strong credentials, such as a driver’s license or other established identity. We understand the privacy implications of such an approach, but we believe proper safeguards can be put in place to ensure that privacy concerns are met.”

Testimony from Patterson and other stakeholders on health information exchange issues is available here.

Comments (4)
My major concern with the HIEs is the accuracy of the data across all realms. I have a fairly generic Anglo name. In four separate, well respected, major practices my information (including one EHR) has been compromised with data belonging to another patient by the same name. If the physician practices cannot even get it right on paper, how in the name of anything sensible can HIEs be trusted??? I work in an acute care hospital. IF it even can be accomplished, it is a NIGHTMARE to get wrong information corrected in electronic record now. Once it has been pushed out to the HIE .... I shudder to think! I expect I will decide to opt out of the HIE and depend on my medical alert bracelet.
Posted by Susan B | Friday, February 01 2013 at 9:56PM ET
Another vendor cop out, looking for a low bar. One should ask why and how does a project like epSOS (European Project for Smart Open Systems, www.epsos.eu) across the 23 European Union countries with millions of transactions per hour occurring differ from the competing mess of projects and vendors in the US. Its politicians and vendors walking hand in hand lowering the bar and maintaining their need to control their software that is the problem here. Maybe the vendors should show up at an IHE connectathon and do some serious testing. Wonder how many IHE Profiles were validated by Cerner at the IHE Connectathon this week?
Posted by Phil W | Saturday, February 02 2013 at 8:22AM ET
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As the feds ramp up enforcement of privacy and security rules, providers look to fill protection gaps.

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