The Health Information Technology for Economic and Clinical Health Act of 2009 may have spurred EHR adoption, but policymakers must acknowledge its role in diverting developers' focus from innovation, according to an op-ed in The New England Journal of Medicine by two health IT experts.
The authors — John Halamka, MD, CIO of Boston-based Beth Israel Deaconess Medical Center, and Micky Tripathi, PhD, president and CEO of the Massachusetts eHealth Collaborative — laid out issues with current EHRs, which value "processes more than outcomes."
"We lost the hearts and minds of clinicians," they wrote. "We overwhelmed them with confusing layers of regulations."
EHR vendors, too, faced an "avalanche of requirements" as they met increasingly complex certification requirements from ONC. These requirements diverted resources away from product development that focused on user experience, rather than federal regulations. These regulations also lacked appropriate mention of concepts like patient-matching, common guidelines or data exchange governance.
"We expected interoperability without first building the enabling tools," they wrote. To address the need for interoperability, Dr. Halamka and Dr. Tripathi recommended refocusing federal requirements on outcome-oriented quality measures and focusing EHR certification on data-exchange capabilities. The authors also suggested ONC, CMS and related agencies encourage the private sector to connect with one another using open industry standards.
"Instead of recognizing the work that needed to be done on these foundational items, some policymakers invented the myth of 'information blocking' as the root cause for lack of data flow," they wrote. "Our 50-plus combined years in the health IT industry have taught us that when technology, policy and business needs are aligned, data flow."
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