Mostashari pushes for more, Direct expands

Continuing their tradition of releasing requests for public comment related to various elements of the Meaningful Use program right around the end-of-year holiday season, the Office of the National Coordinator for Health IT's (ONC) HIT Policy Committee is set to publish its proposed recommendations for Stage 3. The 45-day comment period should end right around the time we’re ringing in the new year.

While the 38-page report includes a collaborative model of care with shared responsibility and accountability, building upon the previous MU objectives,” ONC head Farzad Mostashari, MD, ScM, pushed for more during the Nov. 7 meeting.

The ability to query patient information should be a top concern, he said, despite immature infrastructure and standards. Patients know that when they go to an emergency room, providers cannot look up their patient information from other healthcare systems. “I want us to reach out and ask again what could we do around querying and the main challenges that have been in place around that complex interoperability. I don’t think it would be responsive if we did not even ask for Stage 3 to move forward on a query-based set of criteria for the certification of EHRs and potentially Meaningful Use. I believe the imperative for exchange is high enough that I want to ask you to reconsider and to reach out and let us be open to the possibility that Stage 3 could include more robust capabilities around queries.”

Interoperability—or the lack thereof—tops the list of complaints users have with health information exchange (HIE) vendors, according to a November report from KLAS.

The top objectives for providers with an HIE included improving care coordination, driving change through analytics and reducing costs through increased efficiencies. Asked to rate vendors on their product’s ability to achieve these goals, providers gave them an average score of seven on a scale of one to nine, with Epic receiving the highest average approval rating at 8.2 and RelayHealth receiving the lowest at 6.

“The HIE industry has one foot stretching to the future as providers’ strategic plans bloom, but the other foot is stuck in the interface mire of incomplete connectivity,” concluded report author Mark Allphin. “Even the most satisfied clients request better interfaces from their vendors. Vendors who can nail down interoperability will be in a better position to meet future strategic needs of clients, including physician engagement, analytics reporting and patient portals.” 

Six state HIEs will receive Direct messaging capabilities from ICA, which develops HIE interoperability technology. 

ICA's CareAlign technology helps users take advantage of Direct messaging in a health information services provider environment, and helps providers start out with Direct and expand to a more complete HIE technology.

More than 4,000 providers are now taking advantage of Direct technology, via HIEs including Central Illinois Health Information Exchange, Iowa Health Information Network, Kansas Health Information Network, Upper Peninsula Health Information Exchange, New Jersey's Meridian Health Systems and Pennsylvania's Allied Health Information Exchange.

Is your hospital one of those taking advantage of Direct technology? Please share your experience.

Beth Walsh

Clinical Innovation + Technology editor

bwalsh@trimedmedia.com