The lack of interoperability is a major impediment to the development of a robust health data infrastructure, according to an independent report commissioned by the Agency for Healthcare Research and Quality (AHRQ), with input from the Office of the National Coordinator for Health IT (ONC).
The report was conducted by JASON, an independent group of scientists that advises the U.S. Government on matters of science and technology. Researchers looked at current challenges that must be overcome in enabling progress in creating a health data infrastructure that can live up to the promise of its many benefits, which include improved care and lowered costs.
More than anything, the researchers say that lack of interoperability among data resources for electronic health record (EHR) systems is holding the industry back. This can only be overcome, the researchers say, by establishing a comprehensive, transparent, and overarching software architecture for health information. They also say that the current criteria for Stages 1 and 2 of meaningful use fall short of meaningful use in any practical sense.
"At present, large-scale interoperability amounts to little more than replacing fax machines with the electronic delivery of page-formatted medical records. Most patients still cannot gain electronic access to their health information," the researchers write. The researchers say that current efforts to define standards for EHRs and to certify HIT systems are useful, but lack a unifying architecture to support broad interoperability.
The researchers recommend that the Centers for Medicare & Medicaid Services (CMS) embrace Stage 3 meaningful use as an opportunity to create a true interoperable health data infrastructure. Also, Stage 3 should enable entrepreneurship, by making EHR software vendors develop and publish APIs. They say that within 12 months, ONC should define an overarching software architecture for health data. This infrastructure should not only allow for interoperability, but protect patient privacy and facilitate access between clinical care and biomedical research.
For its part, ONC has responded in kind with the JASON report. In a Buzz Blog post, Karen DeSalvo, M.D., the National Coordinator for Health IT, said she agreed with the findings of this report.
"I am pleased that this report is consistent with our intent to support nationwide interoperability in a way that supports care, health and is flexible enough to meet the challenges of the future. The ONC and the Centers for Medicare & Medicare Services (CMS) have already begun to work on many of the recommendations cited in the report–although this represents the beginning, not the end of our efforts. The JASON recommendations continue to challenge us to stay focused on the path ahead," Dr. DeSalvo wrote.
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