- In separate responses to two federal requests for information, the association has called for improved EHR data access, analytics, and exchange at the federal level.
In comments from the American Medical Informatics Association published yesterday, the association stated the National Institutes of Health National Library of Medicine (NLM) will lead the medical and research endeavor in leveraging big data to advance nearly every aspect of the healthcare industry. As the association states, big data will be essential to developing new concepts of human disease, designing novel therapies, and training future clinicians and researchers.
AMIA foresees NLM spearheading the charge toward providing curated caches of EHR data for provider, patient, and researcher use, prioritizing research on data standards and emerging technologies, and developing technology, security safeguards, and regulatory models to optimize health information exchange and aggregation.
Focused primarily on patient empowerment, AMIA urged NLM to prioritize direct patient access to their personal health data to encourage active patient engagement and participation. AMIA outlined a series of recommendations the association believes will make these goals attainable.
First, AMIA suggests NLM provide curated EHR databases due to the massive influx of data pouring through the healthcare industry on a daily basis.
The lack of informatics literacy and applied informatics training poses challenges to proper utilization and interpretation of health information, the association notes. A pre-identified, curated big data emulating real-world data from EHR technology along with incentivized research and training programs related to data literacy, research, and development could improve data science, open science, and biomedical informatics advancements.
AMIA contends this approach will enable future providers to leverage EHR data for quality improvement, algorithm development, and the development of a streamlined set of functional data standards.
In terms of advancing biomedical discovery and translational science, AMIA urges NLM to make sharable and comparable implementation resources publicly available, promote research on translation of evidence-based practices, and make negative results available to researchers to inform implementation.
A third area AMIA sees NLM pursuing improvements in is the development of resources that optimize clinician experience — offering a more complete understanding of the modern patient and providing patients transparency to clinician care.
AMIA suggests NLM find ways to make EHR documentation and reporting more practical including developing strong incentives, capable data entry mechanisms, and standards for classifying information. Consequently, the association calls on NLM to prioritize patient empowerment in access to personal health information.
In a second letter published this week, AMIA similarly submitted comments to the Center of Disease Control and Prevention (CDC) regarding how the association can become more of an accessible service for providers in EHR implementation.
Some challenges to EHR implementation AMIA hopes CDC can mitigate include public access to health information, lack of standardization of electronic public health information, and problems with implementing public health information into EHR workflows.
AMIA made several recommendations regarding ways CDC can optimize clinical decision support (CDS), including offering guidance to care delivery organizations and collaborating with other federal agencies to aid value set management.
The association suggests CDC distribute knowledge across various stakeholders by investing in web-based standards and protocols and establishing relationships with knowledge curators.
CDC also asked AMIA for guidance regarding how EHR data exchange might be improved. AMIA recommends making data reporting and return a more streamlined, simplified process in order to avoid unnecessary administrative burden.
In terms of ways the CDC can make clinical data more effective and useful for public health, AMIA suggests CDC redesign its data processes in collaboration with clinical and HIT stakeholders to match the structure in which they are routinely collected by clinicians to avoid excessive data manipulation and make this data easier to use.
Combined, these recommendations are intended to make secondary and tertiary uses of EHR data more efficient.