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Interoperability Plan Underwhelms, Mostashari Resigns: Now What?

Scott Mace, for HealthLeaders Media, August 13, 2013

Moreover, Brazell said, "a lot of people jumped in because they knew that the sand in the hourglass was running out, so they [were] slamming systems in, [and] probably didn't do the right transformation or process change, and now are going, 'okay, we got those first payments, but now we realize we should have done this a little bit differently.'"

Noting that some large organizations are acquiring multiple smaller organizations, Branzell characterizes the work underway as "not multiplicative work, but rather exponential increases in work, because each one of those small systems are pretty tough to convert. I've talked to CIOs all over the country, and that's probably one of their major pain points right now.. the ambulatory conversion factor that they're having to address."

While we try to determine just how much money might have been wasted by these multiple EHR implementations, Branzell said most organizations have not yet begun their work on meaningful use stage 2. How could they? Only a handful of certified EHRs for stage 2 are yet available. In just seven short weeks, providers are supposed to be implementing. It's starting to look like a calamity.

But perhaps we should keep our eyes on the horizon, no matter how rough the trip. One encouraging sign is that CMS is starting to consider making health information exchange part of the criteria for Medicare payment.

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3 comments on "Interoperability Plan Underwhelms, Mostashari Resigns: Now What?"


FLPoggio (8/14/2013 at 11:25 AM)
Underwhelming and a clamity? You bet!. And consider this, here we are almost twelve months from when the first drafts of the 2014 Edition Certification testing (previously known as Stage 2) was issued and all we see are six vendors with fully certified EHRs. Meanwhile all inpatient Stage 1 certifications will terminate as of 9/30/13. As of today major players like Siemens, GE, and Cerner are NOT certified for a full EHR. On the smaller end of the market we are missing; Healthland, QuadraMed and NTT Data (Keane). As I have said on this blog before, the process and details under 2014 are far more difficult than ONC would admit, and as noted earlier the test scripts are still changing. In fact while working through some test data with several of my clients this week we came across three situations where the test data was in error. When we brought this to the attention of the test labs they simply said, "We'll notify ONC, but for now just ignore it".

Michael Matthews (8/14/2013 at 10:03 AM)
While this article speaks to many of the remaining challenges to interoperability, there is a glaring omission of the progress and growth of eHealth Exchange (formerly known as Nationwide Helath Information Network Exchange). In just the past 12 months, eHEX has grown to over 40 participants; has over 100 more in the onboarding queue; has redesigned the testing and onboarding process to become more scalable and efficient; and has engaged HealtheWay to support operations and testing. In addition to private sector engagement, eHEX provides critical access to Federal agencies such as the VA, DoD and SSA. The road ahead will certainly require continued dedication, vision and hard work, but let's pause for a moment to recognize how far we've come and the roadmap that exists for the future. Michael Matthews, Chair HealtheWay Board Immediate Past Chair of eHEX Coordinating Committee

Bobby Gladd (8/13/2013 at 7:21 PM)
"Extend Regional Extension Center (REC) support" How? With NO funding? The RECs are effectively done. I know they recently touted that, but it's an utterly empty proposal, a PR platitude. One presentation topic at the last ONC Annual Conference in DC was "The Grant Closure Process" for RECs.