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ONC stresses flexible EHR strategy

Brian Eastwood | March 11, 2014
The Office of the National Coordinator for Health IT is taking incremental steps to make life easier for healthcare providers struggling to meet the criteria for the meaningful use of electronic health record technology. It's welcome relief for overburdened organizations -- but is it enough to meet their demands for improved interoperability?

That said, many organizations continue to struggle with EHR usability, health information exchange, interoperability and other issues related to EHR use. Russell Branzell, the CEO of one such organization (the College of Health Information Management Executives), says the going is so tough that some organizations "are just giving up" on meaningful use because they (and their vendors) lack the resources to meet the criteria.

At a town hall meeting with ONC officials at HIMSS, providers weren't shy about airing their concerns. Most problems relate to interoperability. Far from simply linking disparate EHR systems within hospital walls, providers want to connect to pharmacies (especially for one-click prescribing), to patient portals (and not just the ones their EHR vendors offer), to affiliated institutions and to immunization registries, among other things.

It's been suggested that providers focus on interoperability "pockets of progress" - the proverbial low-hanging fruit with low costs and high ROI.

That's easier said than done. Want to connect your practice's EHR systems to an HIE entity? Expect each EHR vendor to ask for several thousand dollars to establish that connection. Want to exchange data with an immunization registry? Read up on standards - as Dr. Doug Fridsma, the ONC's chief science officer, puts it, "The good thing about health IT standards is that there are so many of them to choose from."

ONC Understands Healthcare Providers Pain
Amid the frustration, there's hope.

Dr. Karen DeSalvo, the national coordinator for health IT, says Congress is taking interest in breaking down data silos - though she admits that, when it comes to coordinating with Congress on that matter, and others, "I don't have rabbits like that to pull out of my hat."

In addition, DeSalvo says meaningful use stage 3 won't be an endpoint but, rather, the "next chapter" in a process that aims to "power forward on care transformation."

Combine that with the proposed voluntary 2015 EHR certification criteria - part guidance for vendors making EHR systems for providers ineligible for meaningful use, part request for comment on what meaningful use stage 3 should look like - and it's clear that ONC understands the frustrations that healthcare providers face.

Whether the relief will be enough, and whether the right time for it has already passed, remains to be seen.


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