Interoperability Plan Underwhelms, Mostashari Resigns: Now What?

Scott Mace, for HealthLeaders Media , August 13, 2013

"Now we've got some chances to fix stuff, so I think ONC and CMS are both very strongly interested in getting the right things moving in the right direction."

Continuing the direction analogy, Branzell says "we're probably heading in the correct north direction overall. The difference is we're not heading true north yet, which is fine early in a journey, when you're only 50 miles away from your original starting point, if you're only a few degrees off.

"But if you're a thousand miles down your journey, and you start off a few degrees off, you're a long way from your target line. We're still early enough in the journey that we've got to make some of these corrections, and really a lot of this does have to do with the way the law was written, [and] the way the interpretation of standards and certification requirements come out."

Branzell astounded me at one point, noting that some providers are on not just their second, but their third electronic health record implementation.

It's actually not that inconceivable. In the initial rush for the ONC incentive money, too many organizations picked more than one EHR, one for inpatient records and one for outpatient records. That was bound to be trouble.

Not only that, but large organizations have been gobbling up practices and smaller organizations all this time. Numerous acquired facilities have been ripping and replacing their first choice of EHR to match the new parent company's preference.

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3 comments on "Interoperability Plan Underwhelms, Mostashari Resigns: Now What?"

FLPoggio (8/14/2013 at 11:25 AM)
Underwhelming and a clamity? You bet!. And consider this, here we are almost twelve months from when the first drafts of the 2014 Edition Certification testing (previously known as Stage 2) was issued and all we see are six vendors with fully certified EHRs. Meanwhile all inpatient Stage 1 certifications will terminate as of 9/30/13. As of today major players like Siemens, GE, and Cerner are NOT certified for a full EHR. On the smaller end of the market we are missing; Healthland, QuadraMed and NTT Data (Keane). As I have said on this blog before, the process and details under 2014 are far more difficult than ONC would admit, and as noted earlier the test scripts are still changing. In fact while working through some test data with several of my clients this week we came across three situations where the test data was in error. When we brought this to the attention of the test labs they simply said, "We'll notify ONC, but for now just ignore it".

Michael Matthews (8/14/2013 at 10:03 AM)
While this article speaks to many of the remaining challenges to interoperability, there is a glaring omission of the progress and growth of eHealth Exchange (formerly known as Nationwide Helath Information Network Exchange). In just the past 12 months, eHEX has grown to over 40 participants; has over 100 more in the onboarding queue; has redesigned the testing and onboarding process to become more scalable and efficient; and has engaged HealtheWay to support operations and testing. In addition to private sector engagement, eHEX provides critical access to Federal agencies such as the VA, DoD and SSA. The road ahead will certainly require continued dedication, vision and hard work, but let's pause for a moment to recognize how far we've come and the roadmap that exists for the future. Michael Matthews, Chair HealtheWay Board Immediate Past Chair of eHEX Coordinating Committee

Bobby Gladd (8/13/2013 at 7:21 PM)
"Extend Regional Extension Center (REC) support" How? With NO funding? The RECs are effectively done. I know they recently touted that, but it's an utterly empty proposal, a PR platitude. One presentation topic at the last ONC Annual Conference in DC was "The Grant Closure Process" for RECs.




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