The Impact of COVID-19 on Healthcare Information Systems

Interoperability

Data sharing and collaboration play a key role in patient care through the entire healthcare continuum. In our last blog on communication and patient safety, we discussed a study by the Joint Commission on Accreditation of Healthcare Organizations that indicated communication errors were the root cause of almost 70% of all sentinel events (Joint Commission, April 19, 2015). However, even with effective and reliable communication channels, the lack of viable health data and coherent information sharing strategies between health organizations plays an important role in the continued limited effectiveness of front line health workers.

Open Data Sharing At Odds with Privacy Mandates

The COVID-19 response imposes unprecedented challenges on our healthcare system. To address these threats, electronic health information needs to flow across multisystem platforms without impediment. For example, the following scenario for a single COVID-9 patient is not atypical:

  • They may first be screened by a clinic utilizing Telehealth
  • They may then obtain testing at a “drive-through” collection site with services provided from another healthcare system, or have a test performed by one of multiple clinical laboratories with COVID-19 testing capacity
  • They may obtain follow-up through their personal primary care physician
  • Finally, if they require hospitalization, it may be at a location unrelated to any prior providers involved the testing process

Successful care in this complex, dynamic, and all too often ad-hoc system requires a safe, secure, and standardized health information exchange, through both point-to-point (cloud fax and direct) and hub-and-spoke models (health information exchange [HIE] organization.) The current mix of state and federal (HIPAA) privacy regulations poses a confusing maze of barriers for maintaining comprehensive patient care records.  

There are new sources of information and data collection that help manage the pandemic response and mitigation strategies.  Data collection methods such as contact tracing use geolocation data to implement different types of social distancing strategies, including prohibition against large public gatherings and mandated home quarantine. With these new strategies, the availability of patient health information from all systems is necessary at the point of care. Unfortunately, current federal requirements for safe harbors regarding anonymization of clinical data hinder much of the open data sharing strategies that would benefit the fight against COVID-19.

Cloud Fax and Direct Messaging Enable Private Data Exchange

It is clear that unencumbered data exchange that fully meets demands for digital public health reporting is not a fully realized goal at this crucial time. This lack directly affects frontline workers taking care of patients, who are not able to receive all of the structured data necessary for accurate, timely, and effective public health reporting and policy implementation. However, the data management landscape in healthcare is not a complete void. Digital document exchange enabled by cloud fax and direct messaging is an effective means to fill this gap, offering healthcare providers a stable and proven method for sharing complete patient records while adhering to strict standards of HIPAA security.

Massive datasets of patient information are extremely useful during a pandemic. This information allows public health officials to track disease outbreaks, helps clinical caregivers and researchers understand the effectiveness of different treatments, and accurately identify individuals whose immunity poses no risk to the community. Compiling data from multiple sources poses significant technical challenges. However, in the fraught atmosphere of a pandemic, it is important to remember that the creation and use of such datasets — utilizing both unstructured and structured data — also poses challenges for balancing the interests of individual data subjects and the wider community, just as they do under normal circumstances.

Cloud fax can bridge the information gap between disparate systems. This reliable and familiar method of sharing patient health information in a HIPAA compliant format provides an immediate answer to sending PHI to important referral, provider, payer and ancillary partners that have applied different data names, structures, nomenclature, semantics, and code.

Cloud Fax and Direct Messaging Enable Collaborative Care

Complete and accurate patient information is a worthy goal, if not the foundation, of quality medical care. Significant barriers to seamless patient data integration exist across ad hoc and innovative systems of care, limiting the dissemination of vital patient information between providers and insurers. Entities may need to work together across state lines — entities that may be unknown to each other at the time of administration of medical services may need to collaborate to care effectively for the patient. Patients may not be able to choose the provider doing follow-up care, and delays and overhead in information transmission might compromise the effectiveness of the care system. These limitations make it imperative that public health organizations obtain access to new types of data information systems in order to improve the overall quality of care. Because health systems are in varying stages of digital maturity, system implementation, and data governance, it is paramount we embrace all available mechanisms of electronic health information transmission, including cloud fax, direct message and HIEs, and work collaboratively across state and municipal lines toward the goal of patient safety during this unprecedented and historic time.

Brenda Hopkins, MBA, BSN, RN
Chief Health Information Officer
J2 Global – Cloud

Brenda Hopkins