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‘Meaningful’ EHR? Not Without Interoperability

October 5, 2012
Written by: , Filed in: Practice Management
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If electronic health records are stored in the computer system of each health-care provider, not accessible via the computers of other providers, then how do they differ meaningfully from paper records sitting in file cabinets?

Four members of the U.S. House of Representatives raised that issue in a letter sent Thursday to Health and Human Services Secretary Kathleen Sebelius. The letter, which can be found here, asked the secretary to “immediately suspend the distribution of incentive payments until your agency promulgates universal interoperable standards.” It concludes:

We strongly urge you to change the course of direction of the Meaningful Use incentive program. It is critical that your agency do everything possible to advance interoperability and meaningful use of HIT, not just in name only.

The letter’s four signatories are Republicans: Ways and Means Committee Chairman Dave Camp of Michigan, Fred Upton of Michigan, Wally Herger of California, and Joe Pitts of Pennsylvania. Of course the issue became politicized. Farzard Mostashari, MD, who works for Sebelius as national coordinator for health information technology, dismissed the criticism.

According to Health Imaging, Dr. Mostashari, speaking during the CMIO Leadership Forum in Chicago, responded by saying the period immediately before a presidential election is known in Washington as “the silly season.”

Contrast that with the comments of Mark D. Barner at a Wednesday panel discussion on EHR-sharing problems at the Bipartisan Policy Center in Washington. Barner is senior vice president and chief information officer for St. Louis-based Ascension Health, the nation’s largest Catholic, nonprofit health system.

A recent medical condition led Barner from his family doctor to a specialist and then to a radiologist for an MRI scan. At each step, he said, he had to repeat the tedium of giving each provider his medical information. There was no electronic sharing of the data. His summation:

Boy, it’s a drag.

The panel discussion coincided with the release of a survey of clinicians conducted by the nonprofit organization Doctors Helping Doctors Transform Health Care. It found that while 80 percent of those surveyed said the electronic exchange of health information would have a somewhat or very positive impact on improving the quality of health care, 71 percent said lack of interoperability posed a major hurdle to such an exchange.

Current financial incentives work against interoperability standards. Vendors push their own proprietary systems, incompatible with others, hoping to become a new Microsoft—the de facto standard and thus the dominant player in the industry.

The market might eventually gravitate toward a universal interoperability standard. But the four Republican lawmakers told Sebelius not to wait:

“It is highly counterproductive for providers to have purchased EHR systems that cannot ‘talk with one another’ and cannot perform basic functions because of the insufficient standards set by your agency. You are missing an opportunity to reduce duplicative, unnecessary, and even harmful care.”

There’s nothing silly about those suggestions.

* * *

Fired University of Iowa radiology professor Malik Juweid, MD, agrees to no longer practice medicine in Iowa. See our Facebook page for the latest in this long-running mega-dispute.

Related seminar: Radiology Review


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