At eHealth’s high peak sits Interoperability (IOp). Reaching the summit’s a test of preparation and endurance. The view from the top might be breath-taking, but the ascent’s a continuing challenge.
A report from the US Government Accountability Office (GAO) has identified some of these. They’re essential lessons for Africa’s health ministries and systems. ELECTRONIC HEALTH RECORDS HHS Needs to Improve Planning and Evaluation of Its Efforts to Increase Information Exchange in Post-Acute Care Settings sets out five important findings from stakeholders about the US IOp project:
- Facilities often have limited financial resources for the initial costs of EHRs
- Additional costs may be incurred for exchanging information and maintenance
- Implementing standards: concerns are:
- Variability in implementing health data standards
- Difficulty finding health information relevant to post-acute care providers when this information’s exchanged
- Workflow disruptions: implementing EHRs needs post-acute facilities to change their daily work activities or processes, which can be disruptive
- Technology challenges: such as EHRs that can’t exchange health information electronically
- Staffing: a lack of staff with expertise to manage EHRs and high staff turnover result in a constant user training.
There are other challenges too. The Department of Health and Human Services (HHS) hasn’t measured the effectiveness of its efforts to promote EHRs. It also lacks a comprehensive plan to meet its goal to increase the proportion of post-acute care providers exchange electronically. These gaps are seen as inconsistent with leading principles of sound planning.
Current planning excludes key external factors and risks that may affect its efforts adversely. Without a comprehensive plan to address these, risks of not achieving goals. Consequently, HHS cannot determine if its efforts contribute to its goal, or if they need modifying.
The Office of the National Coordinator for Health Information Technology (ONC) plans to survey providers in post-acute settings to collect baseline data on EHR adoption rates and activities to
demonstrate ways to exchange health information electronically. Currently, they don’t extend to assessing HHR’s effectiveness in promoting EHRs use. In addition, most of the key efforts lack specific plans for evaluating their progress.
HHS accepts the findings. It plans to improve its tracking of EHRs use in post-acute care if resources become available. The constructive dialogue reveals the way that Africa’s programmes for EHRs should proceed up the mountain, one step at a time, where each step adds to the ascent.