No 'walled gardens' on the path to exchange, warns Mostashari

The capability to exchange health information that is structured and coded in standard format must exist across vendor products – and not just within single vendor EHRs within a large provider system – for true interoperability, says Farzad Mostashari, MD.

The national coordinator for health IT put vendors on notice that ONC will be scrutinizing the progress of interoperability in 2014 and looking toward meaningful use stage 3.

“We will pay close attention to whether the requirements in the rule are sufficient to make vendor-to-vendor exchange attainable for providers," he noted in an Aug. 28 blog post. "If there is not sufficient progress or we continue to see barriers that create data silos or ‘walled gardens,’ we will revisit our meaningful use approach and consider other options to achieve our policy intent."

Those options could include “other policies to strengthen the interoperability requirement included in meaningful use, as well as consider other regulation,” Mostashari said during an Aug. 24 webinar, sponsored by the National eHealth Collaborative, a public-private group that aims to accelerate meaningful use of health IT.

[See also: 5 Hot Topics in Healthcare Interoperability.]

In 2014, electronic health records (EHRs) will need to be able to perform a number of functions using standards that will make actual information exchange possible for transitions of care, for discharge from a hospital and for sharing with patients. Information needs to follow the patient regardless of geographical, organizational or vendor boundaries, said Mostashari.

The meaningful use Stage 2 final rule, released Aug. 23, defined the common data sets for summary of care records and detailed the measures that providers complete to be eligible for incentives.

The Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition, described the technical functions and features that vendors must incorporate in EHRs to make meaningful use possible for providers. 

"The requirements of the final rule assure that exchange occurs through ‘push’ or ‘query’ methods, while avoiding undue burden on providers and vendors to track and measure this exchange,” said Mostashari. 

“We continue to believe that vendor-to-vendor standards-based exchange being attainable for all meaningful EHR users is of paramount importance,” he said during the online presentation.

“I want there to be no question about the seriousness of our intent on this issue," said Mostashari. "The bottom line is, it’s what’s right for the patient, and it’s what we have to do as a country to get to better health, better health care and lower costs. That’s what meaningful use is all about."