EHR Interoperability a Growing Political Concern

Much ado has been made over each presidential candidate’s stance on the Affordable Care Act.

Now, as the upcoming presidential election nears, voices of contention are also growing louder over healthcare IT initiatives - namely, Stage 2 of CMS’ “meaningful use” EHR incentive program.

In an three-page letter to HHS Secretary Kathleen Sebelius dated Oct. 4, Reps. Dave Camp (R-Mich.), Fred Upton (R-Mich.), Wally Herger (R-Calif.), and Joe Pitts (R-Pa.) bashed Stage 2 of the program on several counts, including its failure to achieve EHR interoperability.

“In 2009 … Republicans expressed support for efforts to achieve interoperable health information technology systems,” the letter stated. “The Stage 2 rules fail to achieve comprehensive interoperability in a timely manner, leaving our healthcare system trapped in information silos, much like it was before the incentive payments … More than four and a half years and two final Meaningful Use rules later, it is safe to say that we are no closer to interoperability in spite of the nearly $10 billion spent.”

In response, a number of healthcare organizations and other groups have voiced their support for the EHR incentive, including Stage 2 rules.

“While there is still much work to be done, HIMSS observes that adoption of secure, interoperable health IT systems continues to grow,” a statement from the Healthcare Information Management Systems Society reads.

Additionally, analyses in two reports by the Bipartisan Policy Center, also released October 4, contradict claims made by Republicans. One of the repots, based on a survey of 527 physicians on health IT issues, states that physicians see potential for EHR exchange to positively impact healthcare performance.

Still, it’s no secret EHRs aren’t popular among conservative-leaning politicians, and many physicians. So should physicians with EHRs fear (or celebrate) the “meaningful use” program’s detonation, should Mitt Romney get elected?

Probably not, according to ONC chief Farzad Mostashari, who recently spoke on the topic at a Chicago meeting of chief medical information officers. Mostashari, when asked during a question-and-answer session about the letter, noted that healthcare organizations have made plans based on the EHR incentive, and are looking for that money to be paid, Modern Healthcare reported. “This is a commitment that we cannot lightly pull back,” Mostashari said, adding that rescinding the program would require legislation that would have to pass both houses of Congress, and be signed by the president.

Robert Tennant, senior policy advisor for the Medical Group Management Association, told Physicians Practice that while “anything is possible” and regulations can change, doing away with EHR program altogether would be difficult. That said, the letter from Republicans does shed light on the challenge of interoperability.

Although Stage 2 requirements for achieving meaningful use only call for an exchange of data between providers and outside clinicians for 10 percent of transactions, many healthcare outlets that providers interact with - such as home health agencies and skilled nursing facilities - don’t have to meet meaningful use and therefore won’t necessarily have certified EHRs in place for transactions to be completed.

“Providers increasingly have the capability of doing this, and the rest of the industry will need to catch up,” said Tennant.

In fact, the Stage 2 goal of having just 10 percent of transitions of care being done electronically, which the Republican letter laments, may actually be too stringent, he added.

“Everybody wants the same goal, I think that’s the generic message of the letter and from the Administration,” said Tennant. “The problem is, how do we get there when we have such a divergent group of care settings and stakeholders? That’s the challenge.”