ONC: Interoperability up, but barriers remain

Providers are continuing to adopt electronic health records and share patient data, and the U.S. Department of Health and Human Services and the Office of the National Coordinator for Health IT will continue to support these efforts, according to their annual report to Congress on the HITECH Act.

The report, required by the Public Health Service Act and submitted to Congress Oct. 9, noted that 59 percent of hospitals and 48 percent of physicians had at least a basic EHR system, up 47 percent and 26 percent respectively since 2009, the year that the HITECH Act was enacted. As of June, 75 percent of eligible professionals and 92 percent of eligible hospitals and critical access hospitals have received incentive payments pursuant to the Meaningful Use program.

However, while more than six in 10 hospitals have electronically exchanged patient health information with a provider outside of its organization--a 51 percent increase since 2008--only 14 percent of physicians have done so. The report identifies several barriers to interoperability, including unchanged provider practice patterns, the lack of standardization among EHRs and the lower priority placed on EHRs by providers who are ineligible for the Meaningful Use program.  

"Stage 2 of the EHR Incentive Programs should serve as a catalyst for promoting the exchange of clinical information across organizational boundaries and EHR developer platforms," the report concludes. "In addition to the EHR Incentive Programs, HHS will continue to promote the widespread adoption and use of health IT to support better care, better health, and improved efficiency through collaboration with public and private partners, the development and integration of policies and technical standards, and investments to improve health IT usability and safety."

Several steps HHS plans to take include new regulations, guidance, programs and a road map to interoperability.

In a related blog post, National Coordinator for Health IT Karen DeSalvo and Matthew Swain, a program analyst in ONC's Office of Economic Analysis, Evaluation and Modeling, reported that they are "working aggressively to continue this process." They also pointed to several important ONC-supported milestones that have been met, such the success of ONC's regional extension centers in helping providers meet Stage 1, the training of more than 20,000 students in health IT via ONC's workforce development program, and its state health information exchange program, which helped make data sharing more available.

Stakeholders have expressed concern that EHRs, even those certified for Stage 2 of Meaningful Use, lack the ability to effectively share data. Providers also have reported that not all vendors support interoperability, with many saying that any progress they've made has been largely due to their own efforts.

To learn more:
- read the report
- here's the blog post

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