MedStar's Peter Basch: Interoperability requires 'significant' MU change

The Meaningful Use program has become an impediment to achieving its own goal of meaningful interoperability, Peter Basch, M.D., medical director for ambulatory EHR and health IT policy for Columbia, Maryland-based MedStar Health, writes in a commentary at Health Affairs.

While the Office of the National Coordinator for Health IT's 10-year roadmap should be applauded, Basch writes, the one-size-fits-all approach of Meaningful Use has "created market pressure for systems that satisfy regulations, as opposed to meeting the needs of providers and patients."

He also says that the addition of interoperability without ensuring that systems can be tailored to clinician needs could lead to the burden of an overload of information, which would do nothing to help patients.

Health industry groups have also been pushing for changes to Meaningful Use. For instance, in a letter sent Oct. 15 to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell, healthcare associations--including the American Medical Association and the Medical Group Management Association--and provider systems wrote that "without changes to the MU program ... we believe that the opportunity to leverage these technologies will not be realized."

Another problem is having electronic health records only just talk to one another, Basch says. That won't fix problems like mediocre information displays and poor anticipatory guidance--which have an impact on prevention and proactive management of chronic diseases in patients, he writes.

In addition, Meaningful Use has no authority over all key stakeholders in the industry, Basch says. An example is with electronic formularies, which he calls no more accurate than their paper counterparts.

"Misleading, inaccurate and/or non-usable information is not made any more useful when digitized and electronically shared," he writes.

Without significant change to the Meaningful Use program, the industry is unlikely to see improved interoperability that allows EHRs and other health IT to fulfill the promise of better, safer, and more affordable care, he concludes. 

Meaningful Use attestation data released this week by the Centers for Medicare & Medicaid Services was dubbed lackluster by a handful of healthcare organizations, including the College of Healthcare Information Management Executives, the American Medical Association and the Medical Group Management Association. Only 43,898 eligible professionals and 1,903 eligible hospitals attested for the 2014 reporting period, as of Nov. 1.

National Coordinator Karen DeSalvo said interoperability won't come easy during the Workgroup for Electronic Data Interchange's fall conference last month.

"We are spending a lot of energy making sure that we avoid throwing the baby out with the bathwater ... by relying only on federal processes or rulemaking. ... We don't want to end up with a road map in January that doesn't speak to people, that people don't see themselves on," she said. 

To learn more:
- read the commentary