The U.S.'s top e-health official urged healthcare organizations to tear down the barriers to effective exchange of e-health records in a message to healthcare providers.Dr. David Blumenthal, national coordinator for Health Information Technology, addressed healthcare providers in an electronic message Nov. 12. Blumenthal's office is charged with fleshing out the Health Information Technology for Economic and Clinical Health (HITECH) Act requirements of the U.S. American Recovery and Reinvestment Act (ARRA) of 2009. In one of a series of messages explaining the provisions of the legislation, he said:

A key premise: information should follow the patient, and artificial obstacles - technical, business related, bureaucratic - should not get in the way. As a doctor, I have many times wanted access to data that I knew were buried in the computers or paper records of another health system across town. Neither my care nor my patients were well served in those instances. That is what we must get beyond. That is the goal we will pursue, and it will inform all our policy choices now and going forward. This means that information exchange must cross institutional and business boundaries. Because that is what patients need. Exchange within business groups will not be sufficient - the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies' vital needs.

The HITECH Act is "pretty specific about eliminating inappropriate barriers," he said. These include:

- Commercial barriers that "restrict the secure, private exchange of information required for patient care across provider or network boundaries. Some of these arrangments may improve care for those inside their walls. But ultimately, they have the potential to carve the nation up into disconnected silos of information.... Consumers, patients and their caretakers should never feel locked into a single health system or exchange arrangement because it does not permit or encourage the sharing of information."

- Economic barriers.

- Technical barriers which limit interoperability. Information must "follow patients wherever they go."

The HITECH Act also calls for building information exchanges across jurisdictions. Grants for states and state-designated entities totaling $564 million target information exchanges "not only within each state but explicitly as part of a nationwide framework" (italics Blumenthal's). HHS will start announcing awards this winter.

The message from Blumenthal was third in a series, according to HealthcareIT News.

Blumenthal's two previous e-mails, on Aug. 20 and Oct. 1, focused on how electronic health record systems could transform today's "antiquated paper-based system" and on the term "meaningful use." The final definition of meaningful use is expected in December.

The next e-mail is likely to address privacy and security issue, he said.

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