The Health IT Now Coalition is calling on the Office of the National Coordinator (ONC) and the Centers for Medicare & Medicaid Services (CMS) to revise meaningful use criteria in order to strengthen interoperability among EHRs.
"ONC and CMS have done a good job on pushing the envelope on getting a better [meaningful use] program," said Joel White, executive director of the Health IT Now Coalition, which is made up of 65 patient, provider, employer and payer organizations that support the rapid adoption and use of heath information technology to improve care, lower costs and enhance patient safety.
However, White said strengthening the meaningful use standards for Stage 2 will make "more useful the tools needed to provide greater value to patients and taxpayers. Better patient safety and lower costs are really the core positive outcomes of interoperability," he said.
In comments filed May 7 on the proposed Stage 2 rules, the Health IT Now Coalition emphasized "a longitudinal EHR for each patient." White said this would help provide a complete view of a patient's medical history over time. EHRs have the capability to do this now, he said, but the problem is they don't have the interoperability.
The Health IT Now Coalition also recommends allowing meaningful users to attest using exchange standards that are "backward-compatible" to the Direct Protocol.
"The Direct Protocol should be a floor, not a floor and a ceiling," said White. The coalition noted in its comments that, "While this [Direct Protocol] standard may act as a baseline for the transmission of clinical data, we believe it is inadequate to fundamentally enable the long-term interoperability and exchange goals of the meaningful use program, and it should not replace more robust standards that are already in use."
The coalition is also making recommendations to decertify vendors who block information exchange. "There are some in the marketplace that proactively block information exchange from one system to another," said White. "They want to capture market share and have a monopoly on information exchange. This is not a standards issue, but a business practice," and a bad one at that, he said. "It is really undermining the program and we think it should end."
Other recommendations from the Health IT Now Coalition include:
- promoting greater patient engagement;
- implementing standards across Medicare and Medicaid to facilitate care coordination and clinical exchange;
- identifying a core set of data elements for use in every summary-of-care record to better meet the needs of patient populations; and
- aligning standards across programs to facilitate care coordination and clinical exchange.
The final criteria on Stage 2 meaningful use is expected to be released this summer, said White. “HHS does need to get the rules out expeditiously to make the changes that would take effect in 2013,” and for providers to adopt those changes, he said.