Practice Economics

GAO: Physicians, hospitals struggle to achieve EHR interoperability


 

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Physicians and health care organizations are struggling to achieve interoperability, the exchange of data between their electronic health records systems, according to a U.S. Government Accountability Office report.

The report comes as more federal lawmakers press the Obama administration to slow the start of the third stage of Meaningful Use requirements for EHRs.

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The GAO interviewed 18 private companies working to enhance the interoperability of electronic health records at the request of Sen. Lamar Alexander (R-Tenn.), chair of the Senate Committee on Health, Education, Labor & Pensions.

In its report, the GAO found five key challenges that are preventing EHR interoperability:

• Insufficiencies in standards for EHR interoperability.

• Variations in states’ privacy rules.

• Difficulties in accurately matching patients’ health records.

• The costs associated with interoperability.

• A need for governance and trust among the providers and organizations using EHRs.

Many of the organizations surveyed said that the Meaningful Use requirements, passed as part of the 2009 federal stimulus and being implemented in stages, focus more on rules than on the criteria necessary to test the various systems’ ability to interoperate.

Three of the industry representatives surveyed suggested that the Obama administration should at least amend the EHR incentives law to focus on testing systems’ interoperability, while five others called for suspending or scrapping the law altogether.

“We are glad to see the GAO shining a light on the problem,” Dan Haley, Athena Health senior vice president and general counsel, said in an interview. Athena Health was not among those surveyed for the report.

“Nobody who lives and works in the 21st century can possibly dispute the proposition that information technology has the potential to vastly improve the quality and efficiency of health care delivery,” Mr. Haley noted. “Unfortunately, the Meaningful Use program, while well intentioned, has become burdened by granular requirements that impede rather than enhance care providers’ ability to maximize that potential, and do nothing to improve the interoperability of disparate technology platforms.”

Meanwhile, 116 members of the U.S. House of Representatives have signed a letter addressed to both Office of Management and Budget Director Shaun Donovan and U.S. Department of Health & Human Services Secretary Sylvia M. Burwell, asking them to delay the third stage of the law’s implementation until there’s a clearer picture of what metrics will be in the recently passed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which have just opened up for public comment.

“It’s time that we focus on interoperability instead of rulemaking to ensure that these products work for our nation’s providers,” Rep. Renee Ellmers (R-N.C.) said in a statement. “If the administration dives into Stage 3 prematurely, we only stand to aggravate providers and vendors who have already experienced ample challenges in meeting attestation deadlines.”

The Centers for Medicare & Medicaid Services sent the final rule for Stage 3 of Meaningful Use to the Office of Management and Budget in September. The next stage is set to take effect in 2017.

wmcknight@frontlinemedcom.com

On Twitter @whitneymcknight

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