“We are deadly serious about interoperability,” said Centers for Medicare and Medicaid Services chief Andy Slavitt at the JP Morgan Healthcare Conference, “technology companies that look for ways to practice ‘data blocking’ in opposition to new regulations will find that it won’t be tolerated.”
Epic, athenahealth, and other major players involved
Slavitt’s blunt words have heralded a flock of strong moves on interoperability. The New England Journal of Medicine boldly suggested, “Federal health IT policy can promote, and health systems purchasing IT can demand, a uniform, standard, public API for health data.” Epic, athenahealth, and other major EHR companies joined the CareQuality Framework, a commitment to standards that will facilitate health information exchange across systems
Mixed success of previous interoperability efforts
It’s important to note that this isn’t the first time major stakeholders have pushed for interoperability. The Office of the National Coordinator for Health Information Technology was created by President Bush all the way back in 2004, and it was supposed to create a “National Health Information Network.” Fast-forward twelve years and the ONC is publishing advisory documents on interoperability standards, but they are only recommendations and aren’t binding in any way. In 2013, several major EHR vendors started the CommonWell Health Alliance, a trade group dedicated to working out key challenges to interoperability such as patient identity, record locator, and data access management. However, CommonWell ran into trouble when Epic refused to join, citing the $1.4 million-a-year membership fee as one reason. Ultimately, the problems the Alliance set out to solve are still present today.
What will it take for this interoperability push to succeed?
Because of the government backing, this push seems like a serious one. But as past failed attempts have shown, interoperability is a complex and lengthy task. It requires steady participation and investment from multiple stakeholders (insurance companies, federal government, health systems, patients) for many years. It will also likely require payment incentives or penalties from the government, similar to the ones in the 2009 stimulus law that were essential to jumpstarting health IT adoption in the first place.
How healthcare organizations should respond and how cognitive computing can help
Interoperability is obviously a cause worth pursuing, but unless it shows more results, healthcare organizations should be prepared to work with different EHR systems for the foreseeable future. Technologies like Apixio’s cognitive computing platform, which can extract and synchronize data from multiple EHR systems, can help.
Maybe this really is the turning point for the interoperability movement. For the sake of patients, let’s hope so. But until significant progress is made, it’s worth having a plan B.