5. Standards that don’t always lead to uniform approaches
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was introduced as a way to establish more value-based models, and to repeal the controversial Sustainable Growth Rate. In April 2016, the Notice of Proposed Rulemaking for MACRA was released by CMS, and it outlined several ways interoperability would be prioritized. This includes health IT certificate surveillance, HIEs, and assessing data blocking and work flow real time.
“If [MACRA] goes through, it will be a tremendous step forward in understanding and getting to solutions around interoperability. It will help the ONC understand the real-world challenges in health systems,” Wise says. The final rule MACRA had not been released at press time.
The ONC has made interoperability a priority in its 10-year interoperability roadmap. In the next two years, the organization aims to see widespread implantation of standards and support systems that will aid software development. “One challenge with these implementations is that the standards are not always being implemented in the same way,” says Joyce Sensmeier vice president of Informatics for HIMSS North America. “So, even though two systems have implemented the standards, the systems are not necessarily interoperable.”
Sensmeier says that Integrating the Healthcare Enterprise (IHE), which works to promote technology standards in healthcare, has addressed this challenge by publishing profiles that describe specifically how to implement standards for a particular use case or case scenario.
To add further rigor to the goal of interoperability, HIMSS has launched a certification program for EHR and HIE products (ConCert by HIMSS), so that vendors can take their products through a rigorous process of testing and certification, monitored by a neutral certification body, to achieve a seal that the products deliver the interoperability that was promised. “This seal will provide more clarity in the marketplace so that provider organizations will know which products deliver interoperability prior to purchase,” Sensmeier says.