In a new policy approved at the American Medical Association’s (AMA) Interim Meeting, physicians continued to call for penalties to be halted in the meaningful use program. Physicians feel that full interoperability, which is not widely available today, is necessary to achieve the goals of electronic health records (EHRs) — to facilitate coordination, increase efficiency and help improve the quality of care.
The new policy comes on the heels of the recent release of new attestation numbers showing only 2 percent of physicians have demonstrated Stage 2 meaningful use. In response to the new figure, the AMA joined with other healthcare leaders to urge policymakers to take immediate action to fix the meaningful use program by adding more flexibility and shortening the reporting period to help physicians avoid penalties.
“The AMA has been calling for policymakers to refocus the meaningful use program on interoperability for quite some time,” said AMA president-elect Steven J. Stack, M.D. “The whole point of the meaningful use incentive program was to allow for the secure exchange of information across settings and providers and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. Physicians want to improve the quality of care and usable, interoperable electronic health records are a pathway to achieving that goal.”
Guest post by Bettina Experton, MD, MPH, CEO of Humetrix.
The HITECH Act and its $30 billion attached budget mainly focused on building a provider-based health IT (HIT) infrastructure for providers to exchange patient health information. Two years after its implementation and the adoption of Stages 1 and 2 of meaningful use (MU 1 and MU 2) requirements for the use of electronic health records (EHRs), the federal government, EHR industry and providers across the country can claim remarkable results: more than 55 percent of hospitals and close to 50 percent of primary care physicians were using basic EHRs in 2012 (versus 10 percent, and 14 pecent respectively in 2009).
Now that the building of an HIT infrastructure is well underway, the capacity of the newly deployed provider EHRs to allow for health information exchange (HIE) remains limited. The persistent lack of interoperability of the more than 1,200 MU-certified EHRs and the scalability issues attached to provider-centric means of HIE leave policy makers, providers and especially patients wishing for a novel approach to achieving true anytime, anywhere HIE.
In almost all other economic and social activities, personal information exchange is driven by the consumer. In banking for instance, whether it is online, using mobile apps or ATM cards, consumers direct and mediate the necessary exchange of their personal information to enable and complete the desired transactions. The days of mainly bank-to-bank transactions by letters of credit are long gone. The convenience and control of today’s online and mobile banking services make them universally used around the globe.
Lack of healthcare interoperability continues to throw its weight in the road of progress, stopping much traffic in its tracks.
But you know that already, don’t you; you work in healthcare IT. That electronic health records lack the ability to speak with their counterpart systems is no surprise to you. In fact, it’s probably caused you a great deal of frustration since the first days of your system implementation.
From my perspective, things are not going to change very soon. There’s not enough incentive for vendors to work together, though they can and in many cases are able to do so. The problem, though, is that vendors are not sure how to charge physicians, practices, hospitals and healthcare systems for the data that is transferred through their “HIE-like” portals that would connect each company’s technology.
The purpose of this piece is not to diverge into the HIE conversation; that’s a topic for another day. However, this is a piece about what have recently been listed as the biggest barriers physicians face when dealing with the concept of interoperability.
The magazine cites a study in which more than 70 percent of the physicians said that their EHR was unable to communicate electronically with other systems. This is the definition of a lack of interoperability that prevents electronic exchange of information, and ultimately will fuel health information exchanges.
It is notable that 30 percent of physicians said that their EHRs are interoperable with other systems. That makes me wonder if this is a verified fact or perception only verified by a marketing brochure.
Another barrier, according to the report, is the cost of setting up and maintaining interfaces and exchanges to share information. According to this statement, physicians are worried about the cost of being able to transmit data, too, which puts them in line with vendors, who, like I said, are worried about how they can monetize data transfer.
An interesting observation from the piece: “Making progress on interoperability will be essential as physicians move forward with different care delivery models such as the patient-centered medical home and the medical home neighborhood.”
What amazes me about this conversation is that given the purported advantage employees gain from the mobile device movement and how BYOD (bring your own device) seems to increase a staff’s productivity because it creates an always-on mentality. I don’t think it’s a stretch to think the same affect would be discovered if systems were connected and interoperable.
An interoperable landscape of all EHRs would allow physicians and healthcare systems to essentially create their own always on, always available information sharing system that would look a lot like what we see in daily lives with the devices in the palm of our hands.
Apparently, everyone wants and interoperable system; it’s just a matter of how it’s going to get paid for. And moving the data and the records freely from location to location opens up the health landscape like a mobile environment does.
Simply put, this is one issue that seems to resemble our current political landscape: a hot button issue that needs to be addressed but neither side wants to touch the issue because no one wants to or is able to pay for it.
One of the problems with this approach is that if we wait long enough, perhaps interoperability also will be mandated and we’ll all end up on its hook.
So, let’s take a lesson from the mobile deice world and allow for a greater opportunity to connect healthcare data to more care providers on behalf of the patients and their outcomes.