Are Stage 1 and 2 Really Achieving Meaningful EHR Use?

Lack of interoperability among data resources for electronic health records is a major hurdle to the unfettered exchange of information and development of a robust health data infrastructure.

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Comments (3)
I could not agree more. Instead of treating the medical industry's participants as know-nothings who need to be eased into the 21st century, what would have been a better approach would have been to bring together medical professionals, IT consultants, and software vendor representatives for a clearly defined and limited time to produce a set of layout standards for the production of transmissible data to be sent from one medical professional to another. Also, standards should have been established that would have been used to assess software vendor offerings, and succeeding or failing to meet those standards should then have been the determinant of whether or not such software could be advertised as being compliant with federal standards.

Instead, what happened? Each vendor has imagined the world as it prefers to do so. Each clinic or hospital has its own way of doing things. Each doctor's office still looks like a graveyard for used manila folders. Reports provided by one party still have to read manually by someone who receives it, defying the intentions to make such information consumable by digital systems without requiring it to be typed in manually.

Innovation in the standardization of data is really not that difficult to achieve in an industry that is at least 50 years behind the rest of the commercial world. All it requires is the courage to push aside the customary assumption that only medical professionals know how to shape and convey data in the world of medicine. IT people know how to do this far better and how to do it more effectively.

But what IT people don't know, however, is WHAT to convey. It doesn't know what is meaningful to the physician or clinician, so that requires the presence and cooperation of medical professionals. So far, that cooperation has been limited to the specific hospital in which the doctor works or the university in which the researcher works. The across-the-board cooperation that the law intended to spawn has simply not materialized.

So, yes, I favor moving to Stage 3 ASAP. The logjam needs to end swiftly. If it doesn't, then federal law will change in a more Big Brotherly way that few would like or be willing to endure.
Posted by rdefazio | Thursday, April 17 2014 at 1:43PM ET
I agree with Robert except a hold needs to be put on MEANINGLESS USE3 to infinity until the exchange of data is possible. I have 4 years of pt. data on my server that goes no where! Lets think outside the box. Scrap all HIE work, we have an exchange method, its called the internet. We all know how to use it and can be as secure any HIE. Use the cloud type storage to store each pt. data that can be pushed and pulled by all vested parties. With this method all a EHR would need is interface software to covert data to standard form to communiate with cloud server. And this is the cheapest form of data exchange! Get it done.
Posted by mackley | Friday, April 18 2014 at 10:44AM ET
This should have been identified as an essential component of Stage 1 & 2 in the policies formation and implementation guidelines. There are existing standards that could have been the basis for such standards. Another issue may be the lack of a unique identification for each patient, which is also necessary for interoperability across organizations. The possibility of using incorrect patient information would result without this standard.

Being a bit sarcastic, I guess I should expect shortsightedness in government regulations such as "stovepiping" and "incompatibility' issues, since this is how existing agencies approach management of their respective "islands" of power and autonomy. Another classic example of this underlying issue is the difficulties surrounding the A.C.A. (Obamacare) system implementation.

Mike T
Posted by embambt | Friday, April 18 2014 at 11:07AM ET
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