Halamka: 'Probably Time to Retire the Meaningful Use Construct'
John Halamka, MD, the Beth Israel Deaconess Medical Center CIO who is co-chair of the federal HIT Standards Committee, shares his views on interoperability, information blocking, and the lifespan of Meaningful Use.
John Halamka, MD, chief information officer of Beth Israel Deaconess Medical Center, has issues with the way both Congress and the federal government see the state of health information technology. Last week he wrote in his blog about "how Congress… [has] entered the Trough of Disillusionment for EHRs and interoperability."
Halamka spoke with HealthLeaders Media on May 29 about interoperability, Meaningful Use, and information blocking. The transcript has been edited for brevity and clarity.
John Halamka, MD
HLM: Interoperability has emerged as a major issue in the push for health information technology. Why isn't the system where Congress and the Department of Health and Human Services say it should be?
Halamka: Think about Meaningful Use. The idea is—Stage 1—Let's get folks to adopt electronic health records. The country had about a 20% adoption rate. Stage 2 is to get them to start exchanging data. The concept was that, by Stage 3, we would be sharing data for care coordination, population health, genomics, clinical research, and all the rest.
This has always been the plan. So people say, 'Wait a minute. Here we are in the middle of Stage 2. Where's all the interoperability?'
It was a five-year project and we're just at the beginning of where we're supposed to be. We're on course. It's all OK. EHRs are recording data electronically. Systems are sharing data for many purposes—public health, lab results, syndromic surveillance, and transitions of care. And now we get to the next step and there are a few necessary requirements.
HLM: What are those requirements?
Halamka: Suppose you are seeing Dr. Bob over in Cambridge and he needs a copy of your records from Beth Israel Deaconess Medical Center. How do I know how to reach Dr. Bob? What is Dr. Bob's electronic address?
It turns out that Massachusetts has a provider directory that provides that information. Most other states don't. So there is some enabling infrastructure that could be provided at a regional level and national level to help us route information from one place to another.
It's not information blocking. It's not HIT vendors being reluctant or hospitals holding their data hostage.