Pollyanna ONC highlights interoperability mistakes made in the past

I presume that I'm not the only person who finds the occasional disconnect between the Office of the National Coordinator for Health IT's blog posts and the real data behind them amusing.

In the latest example, ONC and the U.S. Department of Health and Human Services' annual report to Congress highlights the progress that has been made in electronic health record adoption but is candid about the barriers hampering data sharing, such as lack of standardization of EHRs, unchanged provider practice patterns, and the low priority that providers not eligible for Meaningful Use incentive payments place on interoperability. The report then outlines how the agencies plan to address the problem, which includes guidance, rules, programs and their new interoperability roadmap.

"The current lack of interoperability among data resources for EHRs is a major impediment to the unencumbered exchange of health information and the development of a robust health data infrastructure," the report states.

But you'd think everything is rosy if you only read ONC's blog post about the report. All you hear about is the "significant increases" in data exchange and EHRs and ONC's accomplishments. The only indication that something is amiss is ONC's reference to setting a "new course" as it navigates a future after the HITECH Act, specifically its implementation of the new 10 year nationwide roadmap to interoperability.

This is hardly the first time that an ONC's blog post has skewed data to its benefit. The agency is positively Pollyanna-like. I understand and respect that. ONC has worked hard, and now that funding is running out for its programs, it needs to refocus if it's going to sustain itself.

And the more fleshed out interoperability roadmap, shared this week, and is a well thought out document. It calls for a collaborative effort to improve data sharing. It details goals for individuals, providers, the population and the public. It seeks to provide identity matching, increase trust in the protection of the shared information, and more EHR testing. It contains a whopping nine guiding principles.

But it begs some of the same questions that we've posed before. What went wrong that now causes us to need a new course? Were the barriers to data sharing avoidable or inevitable? Why was there little call for collaboration and identity matching previously? Why weren't EHRs tested more for interoperability before being certified and put on the market? And why isn't there more trust among stakeholders that would encourage increased data sharing?

And is the new roadmap the best one to use?

It's all too easy these days--particularly with our polarized politics--to lay blame on others when an initiative or concept falls short. ONC doesn't necessarily need to be forced into throwing itself under the bus when it comes to interoperability disappointments. It's not the only entity to blame.  

But clearly some mistakes have been made, as alluded to in the report to Congress. Moreover, the industry has already spent a tremendous amount of time, money and energy on interoperability. We should acknowledge what mistakes were made and learn from them, not pretend that they don't exist. This isn't a second bite at the apple; this is a correction.

At least this time it appears that more stakeholders are being allowed to draw the map. - Marla (@MarlaHirsch and @FierceHealthIT)

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