Measuring interoperability, as may be required under the Medicare Access CHIP Reauthorization Act (MACRA) will be challenging, and one industry group is urging federal agencies to proceed cautiously in setting benchmarks for achieving information exchange.

While DirectTrust filed comments lauding the Office of the National Coordinator of Health Information Technology’s initiative to develop metrics for electronic health information exchange and interoperability, the organiztion’s comments on a proposed rule urged the agency to keep it simple.

David Kibbe, MD
David Kibbe, MD

Further research will be needed as the interoperable exchange of health information among providers, patients and consumers becomes more widespread, said the comments from DirectTrust, a not-for-profit organization created to support both provider-to-provider as well as patient-to-provider Direct exchange.

“Developing meaningful and useful measurements for metrics interoperability “will be a challenging task, given the many complexities surrounding interoperability,” said the comments, signed by DirectTrust President and CEO David C. Kibbe, MD. The interoperability of electronic exchange of clinical information is a relatively new and highly innovative phenomenon. Additionally, the infrastructure standards that make it possible for the electronic exchange are also relatively new and are unfamiliar to many providers.”

DirectTrust’s comments said it supports ONC’s plans to use measures it describes as “electronically sending, receiving, finding and integrating data from outside sources, and subsequent use of information electronically received from outside sources.” However, DirectTrust believes ONC should go one step further and develop baseline measures of fax and mail communications that are being replaced by electronic change.

DirectTrust wants ONC to expand the focus of interoperability measures beyond certified electronic health record (EHR) technology. “It is important to measure activity by any and all exchange partners, notwithstanding that ONC plans to assess interoperability primarily among ‘meaningful EHR users,” its comments said. As other organizations use certified EHR technology, that offers an opportunity “to significantly improve care coordination by participating in interoperable exchanges of health information with EHR users.”

DirectTrust’s comments letter may be accessed here.

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