Achieving nationwide interoperability means navigating legal and market-based barriers. The National Governors Association (NGA) Center for Best Practices has published a road map to assist governors and state leaders in advancing policies for the safe exchange of patient information between providers.

A highly functioning health information exchange (HIE) is a major step forward for clinicians to improve decision-making while reducing errors and lowering costs. . Titled “Getting the Right Information to the Right Health Care Providers at the Right Time: A Road Map for States to Improve Health Information Flow Between Providers," the document is designed to aid in navigating different state landscapes to meet unique needs.

“Ultimately, nationwide interoperability will allow providers inside and outside of healthcare to share information critical to health and social welfare, including clinical, claims and social services data at the individual level as well as for overall population health and research,” the NGA wrote. “The road map, however, is not a comprehensive guide for every aspect of statewide or nationwide interoperability; rather, it is intended to highlight the policies and processes states can consider to increase the flow of clinical information between providers as one component of interoperability.”

Currently, legal and market-based barriers keep the exchange of health information from occurring or hinder the exchange in not allowing for a meaningful use of data. The road map is able to outline steps each state can take to improve HIE, helping to clear the path to nation-wide interoperability.

To increase the flow of information between healthcare providers, states should:

• Create a core team.
• Conduct both legal and market analyses.
• Identify main barriers.
• Implement strategies and evaluate outcomes.

In addressing legal problems faced by states in regard to HIE, the road map gives multiple paths to breaking down barriers. These strategies include:

• Fully align state privacy laws with HIPAA by replacing more restrictive laws and allowing providers and hospitals to exchange data in accordance with HIPAA.
• Partially align state privacy laws with HIPAA by amending statutes to improve information exchange.
• Create standardized consent forms as a “one-stop” method of gaining patient permission to sharing data.
• Provide guidance and education to providers to help them follow state and federal law.

The steps in addressing the states strategies on market barriers include:

• Create meaningful economic interests to encourage exchange of health information.
• Use legislative, regulatory and contracting authority to bolster exchange of information.
• Set a statewide view for intraoperative health exchange.
• Bring together stakeholders to develope a functioning intraoperative HIE. 

Click here for the NGA full report.