Kansas Health Institute | Information For Policy Makers. Health for Kansans.

PHILADELPHIA, Pa. — Medical providers, especially those in rural and small offices, who are shopping for an electronic health record vendor should consider the issue of data portability before making a decision, said David Blumenthal, who until this spring was the national coordinator for health information technology.

Blumenthal spoke today with journalists about health information technology issues at the Association of Health Care Journalists national conference.

Data portability is of particular concern with cloud-based EHR systems — that is, systems that store files remotely via the Internet and restrict access to authorized parties, much like how the popular Google Docs file exchanging site works.

Systems with low or zero data portability effectively tie a medical provider to a given software vendor by discouraging or not allowing bulk file downloads from the remote server. Systems with high data portability would allow a provider to more easily switch to a different vendor should they choose to do so.

Cloud-based systems tend to be most popular with small and rural medical offices because the start-up cost is substantially less. Relatively little computer hardware is needed in-house, which can eliminate the need for in-house IT personnel.

Another speaker on today's panel — Dr. Allen Gee, a neurologist practicing in Cody, Wyoming — spoke highly of his cloud-based EHR system. He said he failed twice at implementing a system based out of his own office because he didn't have the hardware and support to make it work well.

"Now I'm using a cloud-based service," Gee said. In paying the service's monthly fee, he said, "essentially I also hired 100 software engineers, 120 process managers, people working in the back office making sure that I can — in a solo practice in the middle of Wyoming — be able to meet (meangingful use) guidelines."

"Meaningful use" standards are the criteria set by the National Coordinator for Health IT. Providers who achieve meaningful use are eligible for up to $63,750 in federal incentives.

While Blumenthal was head of the coordinator's office — sometimes referred to as the ONC, a division of the Department of Health and Human Services — data portability was not incorporated as part of meaningful use criteria.

Therefore, he said, there currently are no guidelines or regulations on data portability.

"My guess is the next cycle of meaningful use, they will be implementing requirements for portability," Blumenthal said. In the meantime, he said the Kansas Regional Extension Center would be able to help providers make the right decision.

"They will know the best practice for how to deal with. It may not be fully solved at this point, but it's something they're going to be working on," Blumenthal said.