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EHR Interoperability Should be Focus of Stage 3 Meaningful Use, Report Says


Insufficient interoperability among EHR data resources is a “major impediment” to the effective exchange of health information, according to a study commissioned by the Agency for Healthcare Research and Quality.

By Bisk on May 13, 2014
EHR Interoperability Should be Focus of Stage 3 Meaningful Use, Report Says

The creation of a “truly interoperable health data infrastructure” for electronic health records should be the nucleus of Stage 3 Meaningful Use, according to a report by JASON, an independent group of scientists that advises the federal government on science and technology.  

The report, “A Robust Health Data Infrastructure,” calls on the Centers for Medicare & Medicaid Services (CMS) to address the dearth of interoperability among existing data resources for EHRs, which the report calls “a major impediment to the effective exchange of health information.”

Moving to a collective mark-up language for EHR storage is one route to interoperability, but is not sufficient to address every issue, according to the report.

“It is equally necessary that there be published application program interfaces (APIs) that allow third-party programmers (and hence, users) to bridge from existing systems to a future software ecosystem that will be built on top of the stored data,” the report states.

According to JASON, requirements for EHR software vendors should include developing and distributing APIs for medical records data, search and indexing, semantic harmonization and vocabulary translation, and user interface applications. Vendors also should be required to ensure that EHR data can be exchanged through these APIs and used in a meaningful way by third-party software, the report states.

Next Steps

The report recommends that the HHS Office of the National Coordinator for Health IT outline a definition of comprehensive software architecture for the health data infrastructure within the next 12 months, while also establishing committees to carry out the detailed development of requirements beyond the yearlong period.

“Interoperability issues can be resolved only by establishing a comprehensive, transparent, and overarching software architecture for health information,” the report states.

The report suggests that the new software architecture should:

  • Use public APIs and open standards, interfaces and protocols
  • Encrypt data at rest and in transit
  • Separate key management from data management
  • Provide a migration pathway from legacy EHR systems

Dr. Karen DeSalvo, National Coordinator for Health Information Technology, says the CMS is already working on many of the report’s recommendations.

“The JASON report builds upon our understanding of the technical, broad policy and privacy and security issues that are both opportunities and challenges as we advance an agenda of meaningful exchange and interoperability,” DeSalvo, wrote in a recent blog post.

Category: Healthcare