Health information exchange technology has the potential to bring patient information directly from an electronic health record to a provider delivering care.

However, a new Government Accountability Office report has found that providers and stakeholders in four states are facing several challenges with ongoing electronic health information exchange efforts. Barriers include insufficient standards, concerns about varying privacy rules among states, difficulties in matching patients to their records, and costs.

The problem, GAO says, is that the Department of Health and Human Services and its various units lack specific prioritized actions and milestones to address obstacles to successful information exchange. In particular, several providers told GAO that they have difficulty exchanging certain types of health information due to insufficient health data standards. 

"Although HHS has begun to address insufficiencies in standards through its Medicare and Medicaid Electronic Health Record programs, such as through the introduction of new 2014 standards for certified EHR technology, it is unclear whether its efforts will lead to widespread improvements in electronic health information exchange," states the GAO report.

HHS with its Centers for Medicare and Medicaid Services and National Coordinator for HIT developed and issued a strategy document in August 2013 that describes how it expects to advance electronic health information exchange. The GAO  concludes that the strategy does not lay out the "principles intended to guide future actions to address the key challenges that providers and stakeholders have identified," nor does it specify such actions, how actions should be prioritized, what milestones the actions need to achieve, or when these milestones need to be accomplished. 

"Determining specific actions and exchange-related milestones with specified time frames can help to ensure that the agencies' principles and future actions result in timely improvements in addressing the key challenges reported by providers and stakeholders," argue government auditors. This is particularly important for Stage 3 of the EHR programs, they note, which focuses on improving outcomes. HHS and its agencies concur with the findings and recommendations. The full report is available here.

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