Interoperability is a lynchpin for health IT advancement, yet it is lacking, Sen. Mark Warner (D-Va.) told the audience at the Office of the National Coordinator for Health Information Technology 2012 Annual Meeting, Dec. 12 in Washington, DC,
Warner, a member of the Senate Commerce, Science and Transportation Committee, as well as the Budget Committee, was intrumental in forming the bipartisan "Gang of Six," responsible for developing plans to cut the deficit. Prior to entering public office, he co-founded the company that became Nextel.
"We need crystal clear, front-end requirements for systems," he said. "It is not enough to be simply able to send secure e-mails. We need to figure out in the next year or two – not the next five or 10 – how to get equipment made by different vendors to allow for searches, transactions and for exchange of information between different vendors."
[Also at ONC event: Maine tops states in EHR use, meaningful use]
Warner said HIPPA also poses problems. The HIPAA law restricts the use of health data that otherwise could be used to produce better healthcare outcomes. "Yes, we have to protect patient personal data," he said, "but we may have to look at some slight switches needed for HIPAA." He admitted, this will be difficult, and is "opening a can of worms."
He said another barrier to interoperability is the lack of economic incentives to encourage the sharing of data. "This is an uncomfortable space for hospitals and providers," he said. In Warner's view, vendors, too, are slowing down interoperability. They sell EHR systems for a relatively low price, he said, but continue to make money on updates and monthly fees, posing an economic challenge to providers who want to move forward with "a truly robust interoperability system."
Warner also used the old adage: perfection is the enemy of the good. "It's easier to get Republicans and Democrats to agree than it is to get software engineers to agree."
At some point, policymakers are going to have to step in and force standards, even if some providers won't make the grade with their old legacy systems.
[Feature: How the campaigns cast a shadow on HIX, Medicaid -- and why they're poised for the forefront]
Warner was adamant there should be an accelerated timeline for meaningful use. "Some in the House are saying, 'we haven't seen this transformation take place, so let's cut this off (referring to federal funding for EHR incentives). I believe we need to put the pedal to the medal on meaningful use," he said. "We've also got to show that just having meaningful use in legacy systems is not enough."
In closing, he told stakeholders, "Hang in there, stay at it...and dream big. We will see dramatic, dramatic returns, but the ball is in your court."
