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Healthcare Groups to Congress: Don’t Support Stage 3 Delay Without Interoperability Reform

December 8, 2015
by Rajiv Leventhal
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Various healthcare stakeholders—including the Health IT Now Coalition and certain health IT vendors—have written a letter to members of Congress urging them to oppose any delays to meaningful use Stage 3 that do not include changes to interoperability standards.

 The Dec. 7 letter comes at an interesting time—eight days before stakeholder comments for the Stage 3 final rule are due, and about a month after more than 100 medical associations sent letters to members of the Senate and the House urging lawmakers to intervene with Stage 3 of the meaningful use program.

This most recent letter reads, “Delay without reform would rob taxpayers and patients of cost savings while doing absolutely nothing to make the program work well for overburdened doctors and hospitals.” The letter was penned by technology companies such as Intel, Apervita, Oracle, and athenahealth, the Health IT Now Coalition, the National Alliance on Mental Illness, and others.

On Oct. 6, the Centers for Medicare & Medicaid Services (CMS) released both the Stage 3 final rule and the Stage 2 modifications final rule together in a 752-page document. Most health IT leaders responded to the rule with cautious optimism, and many further believed that the required start date of 2018 for Stage 3 is too soon. Specifically regarding the Stage 3 final rule, CMS announced a 60-day public comment period to facilitate additional stakeholder feedback, which is set to end next week.

The letter states that to date, the meaningful use program has failed to achieve interoperability goals that aim to break down longstanding silos in our healthcare coverage and delivery system that needlessly drive up costs and recklessly put patient safety at risk. “What is clear to us is that current requirements and pace of the meaningful use program have taken away time and valuable resources from fixing our nation’s interoperability problem. What is less clear is how the new requirements included under meaningful use Stage 3 will help solve the interoperability problem,” the letter reads.

In that sense, the subscribing organizations say they agree with what the American Medical Association (AMA) and 110 other medical associations said in their letter to Congress regarding meaningful use and interoperability—specifically that “the program has failed to focus on interoperability and has instead created new barriers to easily exchanging data and information across care settings.”

The organizations go on to say that the Administration will need legislative support to effectively facilitate interoperability.  “We support Congress changing the law to address the known defects associated with interoperability,” they say. Specifically, they support the following concepts:

  • Establishing a common definition of interoperability
  • Ending information blocking
  • Supporting adoption of industry-developed standards
  • Basing full electronic health record (EHR) certification on performance in interoperability and usability
  • Testing of EHR products via NIST
  • Easy access of EHR marketplaces
  • Establishing an online tool for reporting problems
  • Applying civil monetary penalties and decertification for bad actors, including those who engage in information blocking
  • Implementing a penalty structure EHR vendors that have committed bad actions
  • Transferring grant authority from ONC to an alternative agency


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