Regulatory and policy barriers to effective clinical data exchange: lessons learned from MedsInfo-ED

The need to deploy automated clinical information systems in hospitals and ambulatory care settings has recently been identified as a top priority. MedsInfo-ED is a proof-of-concept clinical data exchange project that uses prescription claims data to deliver patient medication history to emergency department clinicians at the point of care. The goal of the project is to serve as a prototype for building and testing a community clinical data exchange model that uses available technology and operational solutions for improved quality and patient safety outcomes. This patient safety initiative, while limited in scope and scale, has been crucial in identifying numerous policy and regulatory barriers to successful clinical data exchange. The lessons learned and strategies to overcome the barriers are the focus of this paper. Through commitment and effective collaboration, MA-SHARE was able to address some of these barriers that are embedded in existing government regulations and corporate business practice.