“We have been candid about the key reason for the lackluster performance of this stimulus program: the lack of progress toward interoperability,” GOP Sens. John Thune of South Dakota, Lamar Alexander of Tennessee, Pat Roberts of Kansas, Richard Burr of North Carolina and Mike Enzi of Wyoming wrote in a Health Affairs article. “Countless electronic health record vendors, hospital leaders, physicians, researchers, and thought leaders have told us time and again that interoperability is necessary to achieve the promise of a more efficient health system for patients, providers, and taxpayers.”
The senators added that in the six years since the HITECH Act was passed, there has been inconclusive evidence that the legislation is working to achieve its goals of increasing efficiency, reducing costs, and improving care quality.
Their article comes as ONC is currently accepting public comments on the plan, dubbed Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0, and that comments period will be open until April 3, 2015.
ONC chief Karen DeSalvo, MD, has called the interoperability roadmap and the accompanying Federal Health IT Strategic plan a new horizon for “HIT beyond EHRs” and “policy levers beyond meaningful use.”
DeSalvo has also explained that several actions steps will be needed to reach nationwide interoperability, as Healthcare IT News Editor at large Bernie Monegain reported, and the work will progress along three pathways: standards, incentives to motivate the use of those standards, and a trusted environment for collecting and sharing health information.
ONC has been criticized for the 10-year duration during which it intends to work toward not just interoperable EHRs but the promise of a learning health system built on top of digitized infrastructure — with at least one hospital CIO, Paul Merrywell of Mountain States Health Alliance, likening the timeframe to how long it took to land a man on the moon.
And while Merrywell said last summer during an HIT Policy Committee meeting that he is encouraged by ONC’s interoperability roadmap, he added that “we’re never going to get to interoperability without standards that can be universally applied.”
In addition to standards, the senators called for much more detail than ONC has thus far provided.
“Instead of offering specific objectives, deadlines, and action items, ONC’s roadmap falls short on the nitty-gritty technology specifics that vendors and providers need when developing IT products,” the senators wrote. “We are left with many outstanding questions about how to achieve interoperability and how to address the cost, oversight, privacy, and sustainability of the meaningful use program.”
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