"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.