Urges 'pedal to the metal' on meaningful use
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, co-founded the company that became Nextel before moving to politics.
"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."
Warner said 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 acknowledged, this would be difficult, and would be "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.
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, he said.
"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 a recent commentary, John Loonsk, former director of interoperability and standards at the Office of the National Coordinator, said there is a new degree of pessimism about when interoperability would become reality.
"The issue of progress, or relative lack thereof, on interoperability surfaced just before the election with members from both houses of Congress questioning whether HITECH funding of electronic medical records should be continued without interoperability standards or more rigorous meaningful use requirements in place," he wrote.
"Recent, non-political, Congressional testimony suggested interoperability is still another decade away,' he says. "And there are enough renewed discussion threads of potential 'interoperability solutions' by newbies and statements of dispirited resignation by old hands to substantiate a serious trajectory problem."
At the recent American Medical Informatics Association (AMIA) Annual Symposium in Chicago, Charles Jaffe, MD, CEO of standards development organization Health Level Seven International (HL7) described a "circle of blame" involving government agencies and regulators, hospitals and healthcare systems, technology vendors, clinicians, academicians like those at AMIA and, yes, standards development organizations (SDOs), such as HL7. "The policy always preempts the technology," said Jaffe.
"And just like [in the 1983 Cold War movie] WarGames, in this finger-pointing, no one wins." He noted that not-for-profit HL7 in September made most of its standards and other intellectual property available free as a means of building trust for HL7 communications messaging. "Without trust, none of this is possible," Jaffe said.
Contributing writer Neil Versel contributed to this article.
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