GAO report: Meaningful Use presents a hurdle to achieving interoperability

Despite the importance of electronic health record interoperability to improving the state of overall care delivered in the U.S., several hurdles remain to get to seamless patient data exchange between providers, according to a new Government Accountability Office report.

Two issues hindering interoperability, according to some interviewed for the report, are the lack of incentives for providers to share data currently and the requirements for the Meaningful Use incentive program. 

Eight of 18 nonfederal initiative representatives interviewed said that the Meaningful Use programs increased adoption of EHRs, but five suggested pausing or stopping the program.

One-hundred sixteen members of Congress this week signed a letter addressed to Health and Human Services Secretary Sylvia Mathews Burwell and Office of Management and Budget Director Shaun Donovan urging a delay for Stage 3 of the Meaningful Use program. Donovan and Burwell also received letters earlier this month about delaying the next stage from the American Medical Association and 41 medical societies.

Sen. Lamar Alexander (R-Tenn.) has also called for a delay of Stage 3. 

Meanwhile, "representatives from 10 of the initiatives noted that efforts to meet the programs' requirements divert resources and attention from other efforts to enable interoperability," the report's authors said. "For example, some initiative representatives explained that the EHR programs' criteria require EHR vendors to incorporate messaging capabilities into EHR systems, but this capability generally does not enable interoperability at this time."

Additionally, representatives from 10 of the initiatives called the criteria to certify EHR systems within the Meaningful Use programs insufficient to achieve interoperability; three recommended adjusting such critiera to focus on testing for the ability to interoperate.

Initiatives interviewed included the Argonaut Project, the CommonWell Health Alliance and the eHealth Initiative.

The report also outlined five key challenges to EHR interoperability, which the responding initiatives are working to remedy, including:

  1. Insufficient health data standards
  2. The differing privacy rules across state lines
  3. Matching patients with their health records
  4. Costs associated with interoperability
  5. Lack of agreements between providers to share health data

To learn more:
- read the GAO report (.pdf)

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