The US and UK are working together on harmonising quality indicators, releasing and using health data, the Blue Button initiative and the interoperability of electronic patient record systems.

Chief technology officer at the US Department of Health and Human Services, Bryan Sivak, spoke at the Health and Innovation Expo in Manchester this week and detailed the projects on which the two countries are collaborating.

NHS England and the Health and Social Care Information Centre signed a healthcare IT memorandum of understanding with the US Department for Health and Social Services in late January.

Sivak said the MoU has four work streams and the first is the sharing of quality indicators.

“The idea is that if we can harmonise the way we develop quality indicators for various conditions across the two countries, we can start looking at patterns of care. [This] isn’t possible [at the moment] because we don’t have the same way of looking at things,” he explained.

Sivak said the first two quality indicators being worked on are for depression symptoms and knee and hip operations.

The two countries are also looking at “liberating health data and putting it to work”, said Sivak, adding that the US has been working on this for three years, and recently reached a milestone of releasing 1,000 datasets.

Against the background of the ongoing row over England’s programme, he said the US has a robust process for what data is released and who gets access.

“We would love to work with the UK so the data released on our side is comparable to data released here. Then we can suck it into similar applications and have a much larger visualisation of these various conditions,” he said. will combine the well-established Hospital Episode Statistics with new datasets drawn from GP practices and other sources.

It has proved controversial because of a botched leaflet campaign, and because patients, privacy campaigners and health professionals are concerned that the information may end up in the hands of insurance and other commercial companies.

In response to a question from the floor, Sivak said that medicare data released by the US government cannot be given to private companies.

The third workstream is around the Blue Button initiative, which aims to allow US patients to download a standardised version of their medical record.

“If we can implement the Blue Button specification here and in the US simultaneously, then applications developed for use in the US can work here and vice versa, creating a more robust ecosystem,” Sivak said.

This workstream is more widely about, “priming the health care IT ecosystem to make it as easy as possible for health care entrepreneurs to do interesting things in the UK and US”, he added.

The final area of work is around adoption of electronic health records. Sivak said that while the UK is advanced in its use of IT in primary care, the US has worked hard to achieve 80% adoption of EHRs, used on a daily basis, in its acute hospitals.

The next step is getting all of the systems to talk to one another, which can be difficult in a market where participants are not encouraged or incentivised to interoperate. This is another area where the US and UK can work together.

“I would love to see a broad and bold goal in both countries to say that by 2020, any patient can walk into any care setting, tap a couple of buttons on a keyboard and have their relevant records for that particular visit,” Sivak said.


EHI editor Jon Hoeksma was at HIMSS14. Read his blog posts from the show about the latest concerns and developments in the US healthcare IT market.