MACRA gives healthcare a fresh start for EHR interoperability, AMA President Steven Stack says

The American Medical Association and the American Hospital Association call on ONC to rethink how it measures interoperability. Rather than simply gauging data exchange, they contend, ONC should focus on better care coordination.
By Bernie Monegain
10:05 AM
MACRA EHR Interoperability

In forceful remarks to the Office of the National Coordinator for Health Information Technology, the American Hospital Association and the American Medical Association, along with several other medical organizations, are urging the government to reconsider how it measures interoperability.

The organizations are responding to ONC’s request for comments on interoperability for MACRA, the Medicare Access and CHIP Reauthorization Act.

"The lack of interoperability is one of the major reasons why the promise of electronic health records has not been fulfilled," AMA President Steven Stack, MD, wrote in a statement. "Vendors have been incentivized to meet the flawed benchmarks under the Meaningful Use program. We need to replace those benchmarks with ones that focus on better coordinated care. MACRA offers that opportunity and we need to take advantage of it."

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Instead of using data exchange as the metric for measuring interoperability, Stack urges CMS to focus on usefulness, timeliness, correctness and completeness of data, as well as the ease and cost of information access.

Stack explained that approach would benefit patients more than counting how many times voluminous documents are sent back and forth.

[Also: Epic vice president: Healthcare must focus on 'interoperability of knowledge']

The AHA, too, called for a change in how interoperability is measured.

“The AHA recommends that ONC expand its scope of measurement beyond just the exchange and use of electronic health information to include whether we have the standards, technology and infrastructure needed to support these goals,” Ashley Thompson, AHA’s senior vice president of public policy analysis, wrote in a letter to ONC and HHS.

AHA also noted that there are many forms of sharing information. For example, hospitals and health systems are sharing information with clinicians and post-acute care providers by offering access to shared data systems. This type of sharing can be more efficient and effective than exchange, AHA said, as the latest data are always available and clinicians with appropriate access rights may view it whenever needed.

"There is no reason to carry over the flawed measures from Meaningful Use," AMA’s Stack added. "MACRA gives us a chance to start fresh and produce metrics that enhance the wellness of patients. We are willing to work with CMS and ONC to get there." 

The American Academy of Family Physicians also weighed in with recommendations. In a June 3 letter to ONC, the AAFP called for interoperability measures that are patient-centric to advance care coordination and continuity. 

Interoperability is a complex task for which a few guiding principles should be adopted, they asserted, recommending the following: measures should not add administrative burden to clinicians or their practices, and multiple data sources should be utilized to measure interoperability.

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