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HIPAA is powerful, but it doesn’t provide the ability for providers and other responsible parties to execute upon its guidelines. (Getty/designer491) Last month marked a milestone in enhancing the protection of reproductive health information. Yet, this plan is only partially complete. Success now depends on the active involvement and collaboration of healthcare providers, patients and the health tech community.  I’ve been privileged to have an active role in and front seat to health data policy development and the maturation of healthcare technology for the last two decades. What it’s shown me is that without a concerted effort to build trust, allocate resources and engage in collaborative efforts to safeguard data, both patients and providers will fall short of reaping the benefits of data sharing and fail to shield themselves from unwarranted or unlawful data breaches. And, when it comes to sharing reproductive health information, the stakes are much higher: A potential breach of information could be life-threatening.  While the Biden administration modified HIPAA to prohibit disclosure of patient health information (PHI) to protect access to reproductive health care, this measure is only as good as the technology that healthcare providers and patients rely upon. This dual perspective—concern and opportunity—should grab the attention of both the healthcare and technology communities. Here are three ways leaders have the opportunity to ensure key federal policy measures like the HIPAA Final Rule can be meaningfully enforced.  Trust through transparency and accountability    Unfortunately, we don’t have to go far to identify recent examples of what isn’t working in PHI security. Just see the impact of the Change Healthcare breach or the fractured relationship between Epic and Particle Health. The lessons drawn from these incidents underscore the importance of accountability whenever PHI is in play. When organizations share how processes and decisions are aligned in a transparent manner, it makes it possible for partners and providers to reciprocate. And this trust and transparency does not need to be one-to-one. Governance and enforcement are also key tenants. Providers in California are implementing the state’s Data Exchange Framework, which mandates certain entities to share information. Through this framework, entities are able to design use cases and workflows critical to defining how policies will affect patient information flows and data sharing, including those related to reproductive health. When entities are willing to hold up and share their work for others to follow—and are supported through formal governance and oversight—it helps keep patient information sharing both purposeful and protected. Consent   I predict that e-consent will be one of the most important battlegrounds for appropriately sharing reproductive health information. While e-consent (consent gained through a digital system instead of a paper consent form) is not new, it represents a key part of the equation for who can and should gain access to reproductive information. This includes enabling patients to be active participants in who is able to see their information. Based on my experience, the key components to successfully manage consent services include the importance of informed consent in facilitating data sharing, thereby enhancing service delivery and improving health outcomes, expediting the adoption of federal legal interpretations of consent to share, advancing technology and policy for consent management, developing standardized consent forms and establishing consent management programs in collaboration with multiple state agencies.  Embracing data sharing infrastructure   Ironically, one of the best ways to prevent unauthorized data access is to improve ways to share data. A stronger data sharing infrastructure, adopted nationally through TEFCA or locally, such as through California’s Data Exchange Framework, delivers strong tools, processes and guidelines. Data advancement is a team sport, and the more people that participate, the more likely everyone will benefit from a unified structure, harmonized regulations and evolving guidelines that focus data sharing on improving patient outcomes and allowing for protections as needed. HIPAA is powerful, but it doesn’t provide the ability for providers and other responsible parties to execute upon its guidelines. While healthcare policy continues to evolve at every level of government, we need to spend the same amount of time and effort in investing in technology innovation, health data sharing policy, consent standards and coordinating efforts between health information exchanges and organizations across the country. Womens’ lives depend on it.  Timi Leslie is president of consulting firm BluePath Health and has over 30 years of experience in the healthcare industry, advising organizations on business strategy, technology innovation, partner relations, product management and system implementation. She also leads Connecting for Better Health, a coalition that strives to improve data sharing infrastructure with a goal of transforming health and social outcomes.

The Michigan Health Information Network, the nonprofit statewide health information exchange, will integrate PointClickCare's cloud-based software facilitating seamless, automated flow of patient data. WHY IT MATTERS MiHIN announced that its partnership with the largest post-acute electronic medical record vendor in the country will now enable 250 new post-acute providers and case managers to exchange real-time data through the HIE. Despite widespread adoption of certified health information systems, many of Michigan's long-term care facilities and emergency medical service providers have not been able to comprehensively leverage the state’s network. MiHIN hopes to advance and deepen healthcare collaboration, care coordination and interoperability by offering access to real-time insights at any stage of a patient’s journey. "PointClickCare will exchange post-acute health information throughout our shared digital infrastructure at an unmatched pace and scale, helping to tie the gaps of post-acute care into the integration and connection of the care continuum," said Dr. Tim Pletcher, executive director of MiHIN, in the announcement. The partnership "will equip participating Michigan hospitals with unprecedented context on emergency department patients at the point of care," added Dr. Ben Zaniello, chief medical officer at PointClickCare. PointClickCare’s emergency department optimization will also be available to hospitals across the state for clinicians delivering care to vulnerable patient groups, like expectant mothers, those experiencing health inequities, those being transitioned from post-acute care and those impacted by opioids. That platform enables emergency departments to access prior patient encounters histories and interorganizational patient care plans in real-time to support their high-risk patients. THE LARGER TREND HIEs have a key role to play in public health reporting , particularly where regional laws vary. California's 2022 single data sharing agreement, mandated by law, addresses an information exchange ecosystem that is often fragmented and siloed across the state. "Data exchange is incredibly local, and I think we all know that," explained Timi Leslie, founder of BluePath Health and a leader at Connecting for Better Health, in a recent HIMSSCast podcast on the Golden State's requirement for real-time exchange of treatment, payment and healthcare operations information sharing by 2024. The COVID-19 pandemic showed the significant gaps in the state's healthcare data interoperability, said Leslie, noting that there are a number of blueprints from other states to follow. "The regional HIE entities know their health system landscape and can navigate the key players, engage public health organizations in dialogue with health system leadership, and can develop interfaces that connect the health system players together," Brian Dixon, a research scientist at Regenstrief Institute, told Healthcare IT News in 2019 . The enduring value, especially as HIEs work in concert with other vendor-driven interoperability efforts, is how they deepen healthcare collaboration. Experts have long pointed to the fact that HIEs can notify providers about clinical events, making them a useful utility. "The fact that the EHRs are more ubiquitous and the fact that they have better interoperability capabilities…those are all assets in the equation of making the nation more interoperable," said John Kansky, president and CEO of Indiana Health Information Exchange, when Healthcare IT News was reporting on the enduring value of HIEs , even as vendor-driven networks such as the CommonWell Health Alliance gained maturity. "But what's often forgotten is that if you go looking for the people that have the last mile wired and/or have the data available – and in some cases have it in normalized, curated repositories, ready to be exchanged – it's the HIEs," said Kansky. ON THE RECORD "We anticipate this partnership will support optimized care delivery, safety, and coordination for patients, and will significantly improve outcomes and lower costs associated with particularly vulnerable populations," said Pletcher. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication.

California is a very big state and boasts some of the world's biggest and most leading-edge health systems. Because of its size, however, the Golden State's health information exchange ecosystem is often fragmented and siloed, with many regional HIEs serving providers in their nearby footprint. In July 2021, California Gov. Gavin Newsom signed bill AB 133 into law. It requires healthcare organizations statewide to link up their data sharing capabilities. The legislation calls on healthcare stakeholders to determine the shape and policies of what that might look like but mandates real-time exchange of treatment, payment and healthcare operations information starting in 2024. Since then, healthcare leaders across California have been working in earnest to make that happen – starting with a data sharing agreement that will help govern information exchange across hospitals, physician practices, health plans, skilled nursing facilities, psychiatric treatment centers and more. It is, in other words, a big and important project. Timi Leslie, founder of BluePath Health and a leader at Connecting for Better Health – the collaborative of public- and private-sector healthcare stakeholders that are helping lead this enormous effort – joined us to discuss the policy and technology challenges around the statewide exchange and highlighted the huge benefits it could achieve for patients and for public health preparedness. Like what you hear? Subscribe to the podcast on Apple Podcasts , Spotify or Google Play ! Talking points: What the existing HIE landscape looks like in California Why it is so fragmented, and how these networks can be linked up What Connecting for Better Health has accomplished so far What challenges lay ahead on the road to the 2024 compliance date What the pandemic has shown us about the need for a comprehensive HIE Why HIEs are also crucial in emergencies such as wildfires and earthquakes How the effort is drawing inspiration from other states' HIE initiatives More about this episode: HIMSSCast: Tracking the present and future state of HIEs California relies on many HIEs to connect state California HIE in revamp mode Connecting Los Angeles: LANES drives interoperability across LA County Santa Cruz Health Information Organization to integrate SDOH data Sequoia Project releases final QHIN application as it moves into operational phase The Indiana Health Information Exchange stays on the cutting edge The key role HIEs can play in value-based care