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cover things in your dataset unless you have a big enough dataset,” he added. “And that requires data interoperabil- ity.” Part of the answer is to build new federal systems “on a flexible cloud- based environment that enables you to build these tunnels, to connect these silos.”
Health data, however, has a unique challenge that better interoperability can’t address: the Current Procedural Terminology (CPT) codes that drive billing and insurance and, by exten- sion, almost every aspect of U.S. health care.
Much of the CPT documentation “is not required to provide care,” one official said. “It is pure boilerplate, and it detracts value.”
“Every service that we offer has to meet that very distorting bar,” he said. “If we’re actually going to have respon-
sive health care, federal agencies can lead the way because as far as I know for their internal service...they do not actually have to use — though they do — CPT codes and CPT code-based treatment plans. But people need to understand how much distortion is put in on every single outpatient health care transaction by the need to define that activity as something that fits the CPT.”
Concerns about security
and burnout
Data security was also a top-of-mind concern for the group, with the risk management required of all federal systems amplified by the unique sen- sitivity of health information.
“I do find it to be different in health care than in just normal IT security,” one executive said. “The value of
health care data is this much higher in the black market because it’s some- thing that you really can’t change about yourself. You can’t just go get another credit card or get another Social Secu- rity number for your health.”
Convincing overextended staff to focus on security risks can be tough, the group agreed. “We’re so far beyond the ages of where a doctor just has to treat a patient clinically or medically,” one participant said. “Now doctors and clinicians have to worry about EHR systems, technology, cybersecurity, what to do, what not to do, how much data is too much and who am I allowed to share things with?”
“That just leads you to overwhelm and burnout,” the official said. “We often tend to look at insider threats and things like that as a malicious act. Most often, it’s really not a malicious
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