NETWORK CONNECTIVITY AND INTEROPERABILITY FOR CONTINUITY OF CARE

To advocate the use of electronic information systems, with appropriate security controls, that enable the integration of patient-specific data that is accessible in all components of a health system; further,

To support the use of technology that allows the transfer of patient information needed for appropriate medication management across the continuum of care; further,

To urge computer software vendors and pharmaceutical suppliers to provide standards for definition, collection, coding, and exchange of clinical data used in the medication-use process; further,

To pursue formal and informal liaisons with appropriate healthcare associations to ensure that the interests of patient care and safety in the medication-use process are fully represented in the standardization, integration, and implementation of electronic information systems; further,

To strongly encourage health-system administrators, regulatory bodies, and other appropriate groups to provide health-system pharmacists with full access to patient-specific clinical data; further,

To advocate that client-vendor agreements include timelines for data destruction; further,

To oppose the selling of data for unauthorized uses; further,

To educate health-system leaders about potential use and misuse of shared data.

Rationale

For the past two decades, the U.S. health system, through the Assistant Secretary for Technology Policy, Office of the National Coordinator for Health Information Technology (ASTP), has supported the adoption of health information technology and the promotion of nationwide, standards-based health information exchange to improve patient care. The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act provided the Department of Health and Human Services with additional authority to promote health information technology, including the secure exchange of electronic health information.

Institutions and practice sites have invested in information systems that work for its specific situation. These systems were developed by multiple vendors, each with their own proprietary structures and labels. Information was and continues to be found in silos, within health systems, within institutions, and even within departments.

As defined by the Healthcare Information and Management Systems Society (HIMSS), interoperability is “the ability of different information systems, devices, or applications to connect, in a coordinated manner, within and across organizational boundaries to access, exchange and cooperatively use data amongst stakeholders, with the goal of optimizing the health of individuals and populations.” ASTP has developed a roadmap for interoperability and created calls to action for entities with specific roles in our healthcare system (e.g., the Calls to Action and Commitments for People and Organizations That Deliver Care and Services). As government agencies, standards-setting organizations, and professional associations work toward interoperability of health information technology, it is important to ensure this includes the ability of healthcare providers and patients to securely access and use health information from different sources and settings relevant to medication use to ensure patient-centered continuity of care.

Along with secure access and health information sharing, providers and health systems must be cognizant of how a vendor will handle data, how it plans to safeguard data, and whether and how data will be used for secondary purposes (e.g., research, advertising). ASHP recognizes that continuity of care is a vital requirement in the appropriate use of medications. Pharmacy personnel with full access to necessary patient specific clinical data have the responsibility for ensuring continuity of care as patients move from one setting to another (e.g., ambulatory care, inpatient care, community pharmacy, home care). Achieving information systems that share relevant patient care data securely across care settings is critical in optimizing medication use across care settings.