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AAFP Letter Rips ONC Interoperability Roadmap

October 13, 2015
by Rajiv Leventhal
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The American Academy of Family Physicians (AAFP) has written a letter to the Office of the National Coordinator for Health Information Technology (ONC) showing concern with the federal agency’s recently released Interoperability Roadmap.

ONC released its final Interoperability Roadmap on Oct. 6 laying out the steps needed to achieve an interoperable health IT infrastructure in 10 years. The final report was the result of months of health IT stakeholder feedback, including public comments from more than 250 organizations, received by ONC in response to a draft Interoperability Roadmap released in January. The report indentifies three overall goals—to help consumers easily and securely access their electronic health information when and where they need it most; enable individual health information to be shared with other providers and refrain from information blocking and to implement federally recognized, national interoperability standards and policies. It outlines a timeline of actions, in three-, six-, and 10-year milestones, to guide stakeholder focus in the near- and long-term

But according to AAFP’s letter to Karen DeSalvo, M.D., National Coordinator for Health IT, family physicians are distressed with the nation's "very slow progress" toward "truly interoperable" electronic health records (EHRs). AAFP Board Chair Robert Wergin, M.D., called for increased accountability on the part of the health IT industry that creates these products and decreased accountability for physicians who have no choice but to use the "inadequate" products. "It is critical to have appropriate technology and data infrastructure to support more efficient and effective health care delivery," said Wergin. However, data collected by the AAFP and other reliable sources show that is not currently the case, the Wergin wrote.

“We need more than a roadmap; we need action,” Wergin continued in the letter. Specifically, he called for: the need for systems that provide interoperability to support continuity of care, care coordination, and the ability to switch and integrate different health IT solutions (such as EHRs) with minimal disruptions; population management and patient engagement functionalities that require broad interoperability; and the new features, as well as the old, need to be developed with user-centered design and take into account the transformed practice environment.

Wergin further stressed the important role of payment reform and expressed concern that the lack of interoperability and the burden of meaningful use requirements were propelling the healthcare system "down a path that is about to collide with the new MACRA (Medicare Access and CHIP [Children's Health Insurance Plan] Reauthorization Act) law requirements."

Primary care practices are working at capacity, said Wergin. "Every minute that physicians and their practice staff (members) spend on managing administrative complexity—and doing the work health IT should be automating—is precious time removed from their focus on patients," he added. As such, the letter called on ONC to delay meaningful use. “This delay would allow for an alignment with MACR and, more importantly, allow for all resources to be directed toward achieving greater interoperability. We do not have until 2024 to improve interoperability.  If we want physicians and other clinicians to transform their practices and be successful in the value-based payment models established by MACRA, then we must ensure that the information technology infrastructure is capable of assisting them versus preventing them from succeeding as is generally the case today,” the letter said. It concluded, “While we appreciate this national interoperability roadmap and its demonstration of ONC’s responsiveness to the health care community, we do not sense the necessary level of urgency to achieve this important goal and call on ONC to further accelerate this work.”

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