Whether it is the interoperability roadmap, Stage 3 provisions, the repeal of the Sustainable Growth Rate (SGR) formula, or the proposed the 21st Century Cures Act, government entities have strongly pushed forward on the interoperability of health IT systems in 2015. But are government regulations and rules the right way to achieve true data exchange between disparate systems?
This was the topic of the latest Healthcare Informatics podcast. Joining us to discuss all things interoperability and government intent was John Stanley, vice president of Impact Advisors, the Chicago-based consultancy.
The development of interoperable mediums and standards allowing for the two-way communication between providers will occur as the “market drives it,” according to Stanley. “The rubber meets the road when the care management and value-based contracts come into play and then the real action begins.”
On the proposed Stage 3 provisions, Stanley says that the Centers for Medicare and Medicaid Services (CMS) is raising the bar too high. He says the move to application programming interfaces (APIs) is a challenge because the standards aren’t even defined. “It’s the right intent but they are putting a high bar against a marketplace that is asking the questions on the collaborations between organizations, rather than the technology standards,” he said.
Stanley said the government’s role in spurring interoperability should be that of a consolidator. “There are too many noisy positions…the interoperability roadmap, Stage 3 meaningful use, the [Rep. Michael C.] Burgess bill, the 21st Century Cures Act. They’re all asking the same questions and muddying the waters in terms of what needs to happen,” he said. “The government needs to simplify the field. People want to play by the rules, they’ve been too flexible and open to interpretation.”
Doubling down, Stanley says regulators need to take the example of the plumbing, railroad, and electric industries. “What made those industries interoperable, by the same definition we’re looking for in healthcare? Well standards made by the vendors, through a reasonable approach from government involvement that creates common interfaces,” he said.
On standards and technologies, Stanley points to two potentials: the use of the Fast Healthcare Interoperability Resources (FHIR) standard from the HealthLeaders7 (HL7) group and protocols from the Integrating Health Enterprise (IHE) framework. The development of these technologies and the business value for interoperability has Stanley cautiously optimistic for the future of data exchange.
“What’s going to make people do things is a firm business requirement and that’s what we’re seeing in these new risk-based contracts,” Stanley said. “That will push interoperability over the edge.”
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