ToC+-+Issues+and+Obstacles

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**Please view the Final Use Case page for the most recent version of this section.**

//Note: The Issues and Obstacles section is now 12.0 instead of 13.0 because of the deletion of the separate User Story section.//

12.0 Issues and Obstacles
In general, the absence of the pre-conditions described in the previous section presents obstacles to implementation of the Use Case.

Additional obstacles are provided below:
 * Variations in local, state and national security and privacy regulations.
 * There are regulations concerning the storage, transmission, or destruction of electronic health information. These regulations are inconsistent across federal, state, and local jurisdictions.
 * Lack of harmonization among data interoperability standards including vocabulary and disease and other messaging standards.
 * Without consistent standards, the viewing, accessing, or transmitting of electronic health information may be inhibited.
 * Incomplete and or inaccurate data or proprietary-formatted information prevents information exchange activities; Consulting Provider may not be able to receive the data
 * A lack of EHR and PHR adoption.
 * A lack of business model and pervasive infrastructure to enable electronic data exchange.
 * Policies do not for a patient’s ability to understand and control clinical information when using a PHR.
 * Translation of medical terminology into layperson terms.
 * There is limited integration of PHRs with provider workflows.
 * State Laws regarding laboratory results.

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