Now that the meaningful use stage 2 rules have been finalized, the direction has never been clearer. While EMR vendors may have dodged a bullet with the interoperability requirements this time around, it is most likely their last chance. With over 800 EMR vendors in the market, interoperability and health information exchange is an uphill battle. ’We are basically asking competitors to collaborate, hoping that there is a solution somewhere that allows information exchange in a standard format,’ says one industry expert. The problem is that these EMR companies carry patent designs and report patterns. While data may become transferable, the reference provider may not necessarily be looking at the same thing as the primary care physician. While the government has moved towards the standardization of the continuity care document, the outcome of its benefits is yet to be seen.
Dr. Farzad Mostashari, the National Coordinator for Health IT has been pretty vocal about the growing need for interoperable EMR solutions. He too believes in the need for a coded and structured format that can enable health information exchange amongst EMR vendors and not just within one vendor network. The ONC plans on paying close attention towards interoperability as it gears up for stage 3. ’If there is not sufficient progress or we continue to see barriers that create data silos or walled gardens, we will revisit our meaningful use approach and consider other options to achieve our policy intent,’ said Mostashari.
Mostashari assures that their intent is serious and standard-based exchange amongst providers carries paramount importance. Health information exchange is essential for the patient. It is what is required to improve care quality and lower costs. Mostashari believes that the certification criteria for meaningful use stage 2 will help ONC set the tone. While the stage 2 objectives only require the provider to show one instance of secure health information exchange with another health organization (including EMR) the certification criteria is likely to be more stringent. He announced that the ONC will be releasing the certification test scripts criteria over the next few months while adding, ’We will have much more rigorous testing in our certification program’. The ONC wants to push standard-based care coordination and exchange by 2014. Mostashari believes that as the switch over begins in 2013 (with the new certified electronic medical records), the healthcare system would effectively be in a different place by 2014.