Two words: Stage 2 (Part 3 of 3)

Today's post is a continuation from our last two days, a discussion of some highlights of Meaningful Use Stage 2 presented by Dr. Farzad Mostashari, ONC Director. Please see Part 1, published Monday, September 3 and Part 2, published on Wednesday, September 5, 2012. We are considering several key concepts in Meaningful Use Stage 2. These are not new concepts, rather concepts that have come into the limelight in Stage 2. 

Part 3 of 3.

Sharing "across vendor boundaries ... and with patients".
In various blog posts over recent months, we have been somewhat outspoken about large health systems. We believe there is significant resistance, especially on the part of health systems, to the open exchange of health information. We've observed massive efforts to create health data repositories - health information exchanges that readily accept data into the system but demand a query in order to get information back out. That's a control tactic, one that we believe is not in the interest of higher quality, lower cost. So, we say three cheers to this statement! "By 2014, providers will have to demonstrate, and vendors will have to support, the actual exchange of structured care summaries with other providers—including across vendor boundaries—and with patients." 

Let's not miss that last part ... "and with patients." The communications door is opening wide to include your patients. Again, no longer is it about giving patients a printed copy of their CCD; it's about sending them an electronic copy the same way you would to another provider - a secure electronic transmission. Can you say Direct? Or how about HealthVault? This is precisely why we have been such strong advocates of the Direct Project, why we have implemented Direct into our EHRs and why we are encouraging our providers to start using personal HealthVault accounts. It's the only way to be ready when your patients begin asking that their Summary of Care be sent to their HealthVault account.

Data silos and "walled gardens".
While I cannot put words into the mouth of the ONC Director, I believe - my opinion - he is addressing the above-mentioned reluctance of some large health systems and state HIEs to embrace the free and direct sharing of health information. This is leadership. This is a heads-up about the transformation of health care. One way or the others, folks, this is where we're going! "As we stated unequivocally in the final rule, we will pay close attention to whether the requirements in the rule are sufficient to make vendor-to-vendor exchange attainable for providers. If there is not sufficient progress or we continue to see barriers that create data silos or “walled gardens ,” we will revisit our meaningful use approach and consider other options to achieve our policy intent."

Nationwide health information exchange.
Let's be clear about the "policy intent". It's about nationwide not statewide health information exchange. It's about open access not controlled access. And it's about direct exchange not circuitous exchange.


Alistair Jackson, M.Ed.

To read Dr. Mostashari's full article, see Meaningful Use Stage 2: A Giant Leap in Data Exchange.