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Adoption and interoperability of EHRs examined in health IT reports

Though the meaningful use program helped exceed HHS’ expectations for EHR adoption in 2013, the lack of interoperability between electronic records has caught the eye of independent assessors and federal health agencies.

Meaningful use stages 1 and 2 “fall short of achieving meaningful use in any practical sense,” according to a report called “A Robust Health Data Infrastructure” performed by the federal scientific advisory group JASON for the Agency for Healthcare Research and Quality (AHRQ). JASON’s report concluded that interoperability often consists of electronically sending page-formatted medical records and that most patients don’t have electronic access to their health information. The report suggests that HHS can improve the interoperability of EHRs by progressively moving them from closed-box systems to open software architecture as part of future stages of meaningful use.

Karen DeSalvo, M.D., the national coordinator for health IT, wrote in a blog post that the JASON report was consistent with the ONC’s intent to drive nationwide interoperability. DeSalvo also stated that ONC and CMS have already begun work to meet many of the recommendations made in the report. In outlining the future of health IT, DeSalvo’s blog indicates a focus on supporting the adoption of EHRs across all areas of patient care. “We will strive to improve our EHR certification program — while we continue our strong support of the standards and technical infrastructure to reach our goals,” DeSalvo wrote.

The ONC has already begun work on tweaking the EHR certification program. They released a proposed rule for 2015 voluntary EHR certification standards and are accepting feedback on the proposal. This is part of their new approach which will update meaningful use standards with small changes every 12 to 18 months. The 2015 voluntary standards will not require providers who met the 2014 requirements to recertify to receive EHR incentive payments, but CMS may tie the 2015 standards to other payment programs.

A HIMSS Analytics report commissioned by Corepoint Health LLC found that some providers found their data was often interoperable and were concerned that limitation would affect their compliance with some meaningful use stage 2 criteria. Despite their concerns, most providers were hopeful that ONC’s commitment to improving HIEs and EHR standards would make interoperability more achievable in years to come.

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