Senior officials in the healthcare sector took aim at the tech companies that provide electronic health records (EHR) yesterday, saying that many of those vendors employ proprietary standards and deceptive strategies to lock providers into their products and keep systems from communicating with one another.
Interoperability has long been a core challenge in promoting the adoption and use of EHRs, and that issue dominated the latest in a series of hearings the Senate Health, Employment, Labor and Pensions Committee has been holding on health IT.
"Information blocking is one obstacle to interoperability," says Lamar Alexander (R-Tenn.), chairman of the HELP Committee.
Alexander says that he and the ranking Democrat on the panel, Patty Murray, met with Health and Human Services Secretary Sylvia Mathews Burwell before Thursday's hearing, and suggests the government hold off on issuing any new mandates on EHRs to allow the industry catch up to the current iteration of the meaningful use standard for Medicare reimbursements.
"My instinct is to say to Secretary Burwell, let's not go backwards on electronic healthcare records, but let's not impose on physicians and hospitals a system that doesn't work and which they spend most of their time dreading," Alexander adds. "Half the doctors are now paying penalties rather than participate in electronic medical records. We want something that physicians and hospitals buy into to help patients rather than something that they dread."
Witnesses at the hearing generally agreed that postponing the deadline for stage three of meaningful use would be a relief to the industry, but they saved most of their ire for the EHR vendors.
Data blocking by vendors remains biggest frustration
"The biggest challenge we face is liberating patient data from EHR systems to make it interoperable," says David Kendrick, chair of the Department of Medical Informatics at the University of Oklahoma and the CEO of MyHealth Access Network. "While many EHR vendors work well with their customers and with our organization to establish interoperability, we still have so many specific experiences with inappropriate data blocking and substandard data quality that we've created a nomenclature to classify" different patterns of information blocking.
Kendrick cited the fees that some vendors charge to make data in their EHR systems fluid, while others don't code entries properly so deduplication becomes impossible, rendering the dataset effectively useless. Some vendors engage in what he called a "bait and hidden switch," where a product achieves certification, but the portability features are stripped away when the system is deployed in the field.
Still others circumvent the portability component of EHR certification to create what Kendrick calls a "Hotel California" problem -- "they can check out other EHR products any time they like, but their data can never leave."
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