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Interoperability Plan Underwhelms, Mostashari Resigns: Now What?

Scott Mace, for HealthLeaders Media, August 13, 2013

"We cannot have it be profitable to hoard patient information and unprofitable to share it," Mostashari said last week. I can't imagine market forces doing it by themselves.

CMS must take more action, and Branzell thinks it's inevitable. States cannot solve this problem by themselves. "My previous organization, a third of our patients came from two other states, because we were on a border," he says. In such a scenario, connecting to the HIE in one state does not solve the state-to-state interoperability problem.

"What we really need is a framework," Branzell says. "I don't think it will adapt as fast as the needs of the industry, whether the [ONC] Standards and Interoperability Framework will really give us those things that we need."

The current approach, built around flexibility and modularity, let the healthcare IT industry "kind of adapt to itself," Branzell says. "The general approach, I think, is flawed. I'm not personally a big government person, but I think there's a really strong place here for the government to much tighter rein in the guardrails of where the variation can occur, to give us a smooth path to where we need to get to."

There you have it – the dog days of summer 2013, a good time for healthcare CIOs to take a break if they can, if they believe that things will turn around when they return in September. Meanwhile, I do wish ONC and HHS leadership all the luck in the world. Losing Mostashari now is the last thing they need.


Scott Mace is senior technology editor at HealthLeaders Media.
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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.