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.

That is the conclusion of an independent group of scientists advising the federal government. To address these interoperability issues, they say the government must establish a “comprehensive, transparent, and overarching software architecture” for health information. 

Though surpassing the 2013 goals established by the Department of Health and Human Services for EHR adoption, the report written by an advisory group put together by MITRE Corporation finds that the criteria for Stages 1 and 2 "fall short of achieving meaningful use in any practical sense" and that "large-scale interoperability amounts to little more than replacing fax machines with the electronic delivery of page-formatted medical records."

As a result, authors argue that "most patients still cannot gain electronic access to their health information" and that "rational access to EHRs for clinical care and biomedical research does not exist outside the boundaries of individual organizations."

The report, funded by the Agency for Healthcare Research and Quality, recommends that the Centers for Medicare and Medicare Services should "embrace Stage 3 Meaningful Use as an opportunity to break free from the status quo and embark upon the creation of a truly interoperable health data infrastructure." 

Writing in an April 16 blog, Karen DeSalvo, M.D., national coordinator for HIT, called the report a "comprehensive and thoughtful look at the technical challenges in our health information technology system." She encouraged stakeholders to take a look at the report's recommendations which are "consistent with our intent to support nationwide interoperability in a way that supports care, health and is flexible enough to meet the challenges of the future."