4 former ONC heads pen op-ed on EHRs' 'path forward' after HITECH

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The Health Information Technology for Economic and Clinical Health Act, which Congress passed eight years ago, spurred EHR adoption. However, moving forward, federal efforts should center the need for data sharing between these electronic systems, according to an op-ed in The New England Journal of Medicine by four former ONC heads.

"The HITECH Act launched an ambitious effort to modernize our health IT infrastructure to meet the demands of the 21st century," the authors, Vindell Washington, MD, Karen DeSalvo, MD, Farzad Mostashari, MD, and David Blumenthal, MD, wrote. "Yet there is still work to be done to ensure that patients and families, researchers and clinicians have access to the information they need."

Today, almost all U.S. hospitals and roughly 80 percent of office-based practices use certified EHRs. However, although the primary goal of the HITECH Act was EHR adoption, the authors noted an issue: the short timeline resulted in imperfect systems, including difficult-to-use software and lack of data-sharing capabilities.

"In part, such limitations are attributable to the decision to allow proprietary standards and data blocking in the market, which has led to suboptimal data sharing," they wrote. "As former national coordinators for health IT, we believe that the culture surrounding access to and sharing of information must change to promote the seamless, secure flow of electronic information."

To make EHRs more interoperable, public and private sector stakeholders must implement common standards to ensure EHRs and other third-party systems can communicate with one another. The latest Health IT Certification Program requirements are a step in the right direction, specifying developers must publish application programming interfaces to enable coordination with additional software apps. 

"Seamless interoperability will facilitate better monitoring of health outcomes, as well as efficient resource use and cost analysis, particularly for care provided in multiple systems and settings," they wrote.

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