Barriers to Pediatric Health Information Exchange.

Abstract

* Abbreviations: CMS — : Centers for Medicare & Medicaid Services DM — : direct messaging EHR — : electronic health record HIE — : health information exchange MU — : meaningful use ONC — : Office of the National Coordinator The Office of the National Coordinator (ONC) included in stage 2 meaningful use (MU) the requirement for eligible providers to transmit a summary of care record electronically for at least 10% of patients referred or transferred to another setting of care or provider of care.1 The transmission of summary of care records, particularly from ambulatory pediatricians to specialists in tertiary care centers or in hospitals caring for children, would be extremely helpful to children and pediatricians and would improve safety and quality of care. Such transmissions would also reduce costs through avoidance of unnecessary testing, duplicate procedures, and allergic reactions, as well as radiation exposure from unnecessary duplicate radiology tests. Regrettably, means to exchange health information among health care entities remain complex, inefficient, and grossly underutilized.2–5 Outpatient pediatricians have 3 ways to exchange records: (1) participate in the Nationwide Health Information Network; (2) use exchange capabilities available through regional delivery networks through electronic health record (EHR) systems with some health information exchange (HIE) capabilities; or (3) direct messaging (DM), a secure and relatively inexpensive method designed for exchange of patient health information across different networks theoretically available to every provider or facility using a certified EHR. None of these options is widely pursued. Neither referring organizations nor outpatient pediatricians have made participating … Address correspondence to Christoph U. Lehmann, MD, Vanderbilt University Medical Center, Suite 1475, 2525 West End Ave, Nashville, TN 37203. E-mail: culehmann{at}gmail.com