AMA-led coalition lambasts current level of interoperability

Lack of capability to exchange info limits value of EHRs, says AMA head Stephen Stack, MD.

Existing metrics for assessing the extent of health data interoperability, grounded in electronic health records meaningful use criteria, are insufficient and should be replaced, the American Medical Association and 36 other societies have told federal officials.

“Despite claims by many health IT vendors that their products are interoperable, the vast majority only exchange static documents in a manner that satisfies minimum meaningful use requirements,” the organizations say in letters to the Centers for Medicare and Medicaid Services and Office of the National Coordinator for Health Information Technology. “Many in healthcare view this level of exchange as little more than digital faxing.”

The medical groups sent comments following an agency request for information on establishing interoperability metrics, which is mandated under the Medicare Access and CHIP Reauthorization Act. They note that more advanced interoperability “means the usefulness, timeliness, correctness and complete of data, as well as the ease and cost of information access. This requires measures that do more than count how many times voluminous documents are sent back and forth.”

“The lack of interoperability is one of the major reasons why the promise of electronic health records has not been fulfilled,” said AMA President Steven J. Stack, M.D. “Vendors have been incentivized to meet the flawed benchmarks under the Meaningful Use program. We need to replace those benchmarks with ones that focus on better coordinated care. MACRA offers that opportunity, and we need to take advantage of it.”

The concern, physician organizations say, is that CMS under MACRA proposes to continue a policy of “counting physician clicks” which will not incentivize software vendors to develop more advanced interoperability functions. They advise the government to focus on specialty-specific interoperability use cases rather than on the quantity of data being exchanged.

A move by federal officials to continue measuring interoperability in its current form without changing the objectives, physicians warn, “will undermine advances in healthcare and will hinder a successful implementation of MACRA.” The letter is available here.

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