Sharing his assessment of the Meaningful Use Stage 2 Final Rule, which was published Thursday, Mostashari said the goal of a national health IT system is to make sure "information follows the patient regardless of geographic, organizational, or vendor boundaries." He also emphasized that there has to be at least one instance in which providers exchange an electronic summary of care with all the clinical data elements between different EHRs.
Speaking during a webcast hosted by the National eHealth Collaborative, Mostashari read a section in the final rule that illustrates the importance of interoperability between EHRs:
"We continue to believe that making vendor-to-vendor standards-based exchange attainable for all meaningful EHR users is of paramount importance. In that regard, and as we look toward meaningful use Stage 3, we will monitor the ease with which EPs [eligible professionals], eligible hospitals, and CAHs [critical access hospitals] engage in electronic exchange, especially across different vendors EHRs."
The document continues: "If we do not see sufficient progress or that continued impediments exist such that our policy goals for standards-based exchange are not being met, we will revisit these more specific measurement limitations and consider other policies to strengthen the interoperability requirements..."
Mostashari went on to emphasize, "I want there to be no question about the seriousness of our intent on this issue. [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 healthcare and lower costs."
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To help health providers working in environments that have a high concentration of one particular vendor's EHR, or others who work in areas where there might be low adoption of EHRs, Rob Anthony, a health specialist in the Office of eHealth Standards and Services at the Centers for Medicare and Medicaid Services (CMS), said CMS will provide a test EHR that will allow providers the opportunity to successfully exchange clinical data electronically between their EHR and the one provided by CMS, as they seek to meet Meaningful Use Stage 2 requirements.
"We do remain dedicated to the idea of health information exchange without borders, across different ….areas of care, but also across different technologies, and that is why we have this third measure that we've introduced here in the final [rule] that at least one of the electronically exchanged summaries of care have to be sent to a recipient with a different EHR vendor,” Anthony said during the webcast.
The issue of EHR interoperability has been top of mind among healthcare leaders who assert that the smooth flow of clinical data across secure IT systems will advance the quality of patient care. In June, a New England Journal of Medicine editorial fiercely attacked EHR vendors for their lack of innovation and resistance to sharing patient information outside of their own closed systems. The authors cited the need to protect market share and reap huge financial rewards as the reasons why vendors retain their proprietary EHR systems.
In the meantime, Mostashari pointed to several significant achievements that will raise the quality of clinical data exchange in 2014, the year when providers participating in the EHR Incentive Programs who have met Stage 1 for two or three years will need to meet Meaningful Use Stage 2 criteria.
Mostashari says ONC has defined a common Meaningful Use data set that facilitates reporting for all summary of care records, care transitions, discharges, and patient access. He also pointed to an impressive array of data elements that are associated with standardized formats and vocabularies that include everything from lab test results, vital signs, and blood pressure readings, to patient demographic information, discharge instructions for hospitals, and provider contact information.
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