EHR Data Valuable Health System Commodity

Electronic health records, or EHRs, offer a treasure trove of patient health data, and now a report by PricewaterhouseCoopers explores the challenges involved with putting those data to good use to improve patient care, predict public health trends and reduce health care costs.

According to the authors of the report "Transforming Healthcare Through Secondary Use of Health Data," (40-page PDF; About PDFs) (free registration required) secondary patient data gathered in the aggregate from EHRs can help identify health trends; predict outcomes; and influence "patient care, drug development and therapy choices." The difficulty, note the authors, is that a lack of standards, privacy concerns and technology limitations may hold back progress.

Results in the report were based on nearly 1,500 survey responses received from health care stakeholders, including executives, providers (defined as physicians and hospitals), payers and pharmacy organizations. The report's authors defined secondary data as "clinical, financial, administrative and self-reported data, which is aggregated, analyzed and presented in a concise, actionable format."

The researchers found that among physicians and hospitals that already were using some secondary health data,

The researchers also found that hospitals and physicians top the list of those who use secondary health data. More specifically, 65 percent of physician and hospital respondents said their organizations were using secondary data, and 70 percent expected that use to increase during the next two years.

The combination of purchasing and learning how to make full use of an EHR was singled out, however, as a significant barrier to using the data. In fact, 47 percent of physician and hospital respondents indicated they hadn't yet implemented an EHR. Reasons these respondents cited for not making use of secondary data included

Although physician and hospital respondents overwhelming supported the concept of mining patient data (95 percent), they understood the sensitivities that surround how that information is used. In fact, 85 percent of physician and hospital respondents indicated that they were concerned about privacy implications in the use of secondary data.

However, Warren Skea, Ph.D., director of PricewaterhouseCoopers' health care advisory practice, told AAFP News Now that participating physicians and hospitals had a "deep-seated and clear understanding of the value of (secondary) data and the knowledge that it's going to provide in the future health care system."

In addition, although many physician and hospitals respondents described data collection as a burdensome task, said Skea, the process should become easier as the health IT industry increases the efficiencies of EHRs and makes them more user-friendly. "Technological advances are going to drive that," he said.

Payment reform also will drive physicians, particularly primary care physicians, to embrace data collection, said Skea. "The reimbursement model is going to change, and those changes are premised on the capture and use of that (secondary) data."

As part of the project, PricewaterhouseCoopers also convened a roundtable discussion to elicit viewpoints from health industry leaders. Those discussions, which are summarized in the report, name patients as the most important group of health care stakeholders. Participants agreed that patients must remain the focus of any health data initiatives, and, therefore, their rights and privacy must be protected.

In terms of privacy concerns, Skea noted that it is critical that consumers are able to differentiate between their personal health information and secondary health data that is de-identified and aggregated. This secondary data is used strictly to identify trends, said Skea. "It's not the individual that we're concerned about." Rather, he noted, the focus is on the patterns that begin to take shape with the mining of data from millions of patients.

Consumer education will help members of the public realize that data collection is about much more than just the collective good, and that using aggregated data will benefit them personally, said Skea. For example, sifting through secondary data will allow researchers and health care providers to identify patients who are at high risk for certain diseases, target diseases before their onset, and learn what treatment protocols patients respond to best.

The federal government's interest in health IT, including the allocation of billions of dollars in stimulus funding, "will drive the exponential growth of data and create even greater opportunity for secondary use," say the authors, but they suggest that the government should avoid creating mandates around health IT.

Rather, the government should focus its efforts on developing incentives to encourage the private sector to collect, share and use health data; establish standards; and rework health IT structures to allow for interoperability between systems.

"Government should act as sponsor, communicator and champion," concludes the report.