Electronic Exchange of PHI might aid Quality of Care

Are government regs stopping us from becoming ‘meaningful users’?


Share information electronically! But see to it that you protect it! According to the latest General Accounting Office study, providers are caught between two competing federal initiatives, and security concerns over protected health information (PHI) might actually be holding them back from achieving improved of quality of care.


As called for by the HITECH Act, the GAO released a study on February 17, 2010 titled “Health Care Entities’ Reported Disclosure Practices and Effects on Quality of Care.”


With the objective of describing how health care entities are disclosing PHI for the purposes of treatment as well as how sharing PHI is affecting quality of care, from May 2009 until the present, the GAO studied more than 60 operational health information exchanges (HIEs) and a selection of each of the exchanges’ participating providers, as found in a GAO summary of the study.


The report addressed two main categories — disclosure practices and quality of care:


Disclosure Practices: The health information exchanges surveyed by the GAO reported that they are using HIPAA’s “Fair Information Practices” that are crafted to protect PHI:


1. Informing patients about how their information will be used and safeguarded


2. Obtaining individual consent


3. Facilitating patient access to and ability to rectify their records


4. Minimizing use and disclosure to specific purposes


5. Providing security safeguards


6. Ensuring the accuracy, timeliness, and totality of data


7. Establishing accountability for the safety of PHI


But while the 18 providers — from large hospitals to small family physician practices — surveyed said they inform their patients about how PHI will be used and protected, two-thirds of them don’t tell the patients that their PHI is being shared through the exchanges, and none of them has implemented electronic consent.


But the GAO points out, “One HIE had developed an electronic tool that its providers use to record patients’ consent preferences that are obtained by other means.


Quality of Care: The report says, “The exchanges stated that they had not conducted formal studies of the effects of electronic sharing of PHI on the quality of care their providers deliver.” However, they offered a few specific instances. Providers who use the exchanges say they are saving time and have better access to more information, which they believe has had a positive effect on the quality of care.


The GAO says, while anecdotal, the data regarding the effect of PHI sharing on quality of care shows that it is having a positive impact. More timely interventions and real-time reporting of data about disease outbreaks were provided by the exchanges as examples.