However, where I disagree is that the issue is inextricably tied to interoperability as strongly stated in the report to the president Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward, released in December by the President’s Council of Advisors on Science and Technology.
Based on the news coverage of this, I thought the report merely called for establishing a "universal language" to help improve interconnectivity. As I’m reading and studying the actual report, I find that it's a major indictment of the current crop of EHRs and calls for a completely new direction—"a transition from traditional electronic health records to the use of healthcare data tagged with privacy and security specifications" so that healthcare information technology can realize its potential to "improve the quality of healthcare and reduce its cost."
The report states that several barriers in the healthcare system discourage market innovation and competition to create effective health IT systems and that "most current health IT systems are proprietary applications that are not easily adopted into the workflow of a clinician's day, and whose proprietary data formats are not directly exchangeable from one system to another." Moreover, it points out that "current electronic health records, which are based on traditional paper records and exist largely within closed health organizations, cannot realize many of the potential benefits" that HITECH seeks to achieve to improve our healthcare system. Amen—we know that to be so true, which is why studies like the recent RAND study have concluded that the current breed of EHRs are not the "silver bullet" that they’ve been proclaimed to be.
The report very bluntly urges a major change in the current approach of HITECH to drive the adoption of EHRs, which it says "creates a danger that EHR adoption during early stages of meaningful use may exacerbate the problem of incompatible legacy systems." Instead, the report emphasizes the need to not replace "one inflexible architecture with another" and says, "What is needed is a simultaneous focus on the capability for universal data exchange, able to unleash the power of the competitive market, to produce increasingly better and less expensive systems, and to create the 'network effect' that spurs further adoption."
Finally, and, I believe, of most importance, the report urges the ONC and the CMS to accelerate the "aggregation of data across organizations," which will be possible only if they expedite the requirement of interconnectivity. The report is a very timely "stop, look and listen" warning to the 80% to 90% of hospitals and physicians lining up to buy and implement EHRs that the "meaningful use" they expect to achieve from their EHRs may not be very meaningful.
Co-founder, chief strategy and innovation officerPHNSDallas