Mostashari counsels family physicians to demand Stage 2 interoperability


Farzad Mostashari, MD, the national coordinator for health IT, wants doctors to "turn the tables" on EHR vendors. In an address to members of the American Academy of Family Physicians last week in Philadelphia, Mostashari urged attendees to demand that EHRs meet interoperability requirements.

"For many years, the dream of adoption of EHRs -- as well as the hope that interoperability standards would emerge from the market, fiercely competing with each other -- would just happen. It was left unrealized," Mostashari commented.

He acknowledged that EHR adoption has doubled among primary care providers in the past two years and predicted that it will reach 50 percent by the end of this year. But the next step, ingrained in Stage 2 meaningful use requirements, is that systems should be able to "truly talk to each other."

"Over the past two years, we brought together 1,000 people who participated in resolving 1,800 valid issues, criticisms and concerns through a standards development organization that needed to reach consensus. And it happened within 9 months," Mostashari said, referring to the Stage 2 development process.

"In Stage 2 of meaningful use, key information was collected, compressed and packaged with 16 data elements over a single ubiquitous transport mechanism that every EHR will have to be able to catch and throw," he added.

Mostashari expects that within 9 to 12 months certified EHRs will be able to meet physicians' interoperability requirements. "Not just in the letter of the law, but in the true spirit of it," he remarked.

"I know that oftentimes when you ask a vendor for anything, they say, 'We can't do it because we're too busy meeting the meaningful use requirements.' This is your chance to turn the table on them and say, 'Meet the meaningful use requirements.'"

Mostashari advised: "If there are products that don't meet the requirements, you have a pipeline that goes to the certification bodies. And those certification bodies will say [to the vendor], 'Hey, you came to the lab and said you were tested to do this. We're now hearing from the field that the product you sold with this ID number is not actually able to do what you said it could do.' I guarantee you that will get their attention, because if they get that certification ID pulled, they cannot sell in the marketplace for meaningful use."

The national HIT chief left the audience with two "magic words" for spurring vendor action on interoperability issues: Stage 2. "Say to them, 'We want you to truly deliver on Stage 2.'"

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