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SSA takes lead on joining electronic health records program

The Social Security Administration will begin using the nationwide health information network on Feb. 28, making it the first agency to test the government's approach to interoperable electronic health records.

MedVirginia, a regional health information organization, has agreed to let SSA officials retrieve the electronic medical records of disability benefit applicants in the Richmond, Va., area, said Debbie Somers, a senior adviser in the Office of the Deputy Commissioner for Systems at SSA. This will reduce the processing time for disability claims dramatically, she said on Wednesday during the 2009 Federal Networks conference in McLean, Va.

The typical disability claim takes 80 to 90 days to process, according to Somers. "Most of that time is spent waiting for medical records," she said. "In our pilot program [with Beth Israel Deaconess Medical Center in Boston] it took less than a minute to retrieve records, with no human interaction on their end."

Somers added that with 3 million people relying on SSA to retrieve their medical records annually, she is delighted that the agency will be the first to use the nationwide health information network.

"SSA is dependent on medical information, so we did a cost-benefit analysis, and felt we had to push in," she said.

The NHIN is a network of networks being developed under the Office of the National Coordinator for Health Information Technology at the Health and Human Services Department. The goal is to provide a nationwide, interoperable infrastructure that will allow federal agencies, state and local health care providers, and consumers to share patient information while safeguarding their privacy. HHS expects to add more agencies to the program later this year, but officials declined to provide details.

Several speakers at the conference touted HHS' progress on the NHIN, but said implementation would be gradual.

"We want to grow slowly so there are no mistakes," said Vish Sankaran, program manager for the federal health architecture program in the HHS Office of the National Coordinator for Health Information Technology. "This the first time we're doing this at the national level."

SSA is on board with the gradual approach. It is canvassing the country for more health information providers that might be interested in participating, Somers said. "We have a lot of learning to do, we have to be careful about how fast we roll out," she said.

The national network will include a gateway where users can search for a patient to determine if he or she has an electronic health record then query and retrieve documentation. It also will allow patients to authorize the agency or health care provider to release their medical information under the provisions of the 1996 Health Insurance Portability and Accountability Act.

Sankaran said privacy and security are the biggest challenges NHIN faces, partly because states have different laws on access to health records. While policy issues such as ownership of a patient's health records could prove thorny, the technology for the network is fairly straightforward, said David Riley, a member of the NHIN team.

The $20 billion for health information technology included in the economic stimulus package President Obama signed on Tuesday will give these efforts a boost, but conference speakers said even that sum is far short of the cost of adopting electronic health records nationwide. Much of the stimulus money will come in the form of grants to help local health care providers purchase the systems necessary to take part in NHIN.

"Cost is a significant barrier to adoption," Riley said, pointing out that it takes $40,000 to $60,000 to outfit the average small medical practice with the necessary technology. "Is it going to cost $20 billion or $80 billion [for the whole initiative]? We don't know. [The stimulus money is] a significant step in the right direction though."

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