Lawmakers focused on the problems created by the lack of interoperability among electronic health record systems at a Tuesday hearing of the Senate Health, Education, Labor and Pensions Committee.
The meeting echoed concerns that five Republican senators made in a Health Affairs Blog post--that the HITECH Act has failed to boost efficiency, cut costs or improve care quality for patients, primarily due to a lack of interoperability.
"The interoperability barriers that exist between providers are driven by a lack of incentives. EHR vendors do not have a business case for seamless, affordable interoperability across vendor platforms, and provider organizations find it an expense that they often can't justify," Julia Adler-Milstein, a health policy expert who teaches at the University of Michigan, said in testimony at the hearing.
She also said that providers in competitive markets are less likely to share data. Robert Wergin, president of the American Academy of Family Physicians, agreed that vendors treat lack of interoperability as a competitive advantage.
"The vendors are siloed and you're held somewhat hostage by the vendor you have. It becomes very difficult to change. Who owns the data? It's a point that makes it difficult to make those changes," he said.
Peter DeVault, director of interoperability for Verona, Wisconsin-based EHR vendor Epic Systems, Inc., defended his company against perceived criticisms, and noted that significant interoperability remains a distance away.
Sen. Tammy Baldwin (D-Wis.) asked why Epic was not a member of the nonprofit trade group CommonWell, which is made up of many of Epic's EHR vendor competitors including Allscripts, athenahealth, Cerner, CPSI, Greenway and McKesson.
DeVault described CommonWell an "aspiring" network, and said that joining would have cost millions of dollars. What's more, he said, participation in CommonWell would have required signing a non-disclosure agreement (NDA), which he suggested meant CommonWell planned to sell data downstream. Epic participates in CareEquality, another interoperability effort.
Following the hearing, Cerner quickly took issue with DeVault's remarks.
"[This] rhetoric is a slap in the face to many parties working to advance interoperability," the company said in a statement. "It was discouraging to hear more potshots and false statements when it's clear there is real work to be done. We're committed to CommonWell as a practical, market-led way to achieve meaningful interoperability."
Committee Chairman Lamar Alexander (R-Tenn.) and Sen. Sheldon Whitehouse (D-R.I.) separately suggested the committee set up more meetings on how to improve Meaningful Use and enable providers to adopt EHRs.
To learn more:
- watch video of the hearing