Dr. John Halamka: 4 thoughts on MU, information blocking and interoperability

John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston, shared some candid thoughts on government incentives regarding health IT, barriers and complaints to information systems and guidelines for moving the industry forward in an interview with Health Leaders Media.

Here are four key thoughts from Dr. Halamka's interview.

On his objections to meaningful use stage 3: "With accountable care organizations and various kinds of patient-centered medical homes, we are starting to develop quality registries and do interoperability. The private sector has incentives to do all this stuff. So, at this moment, we don't really need more regulation. We just need more time.

If you want to put out a few merit-based incentive programs, fine. But it's probably time to retire the meaningful use construct and just let the private sector, with incentives from the [Patient Protection and Affordable Care Act], go forward for the next few years….To create 731 pages of regulations that are going to co-opt the agenda of vendors and providers seems like a mistake."

On making patient identifiers voluntary: "There are always going to be some people who say, 'I don't like anything, whatever it is.' [But] what if I had safe, coordinated, efficient care with mandatory national identifiers? 'That's too much government. I worry about my privacy, and I don't want a national identifier. I'm a human, not a number.'

There are others who say, 'If my care would be more efficient and safer and higher quality, I would very happily have an identifier for healthcare because I don't want the wrong kidney removed.' So, with that spectrum, the only thing we can do is voluntary."

On the myth of information blocking: "I have never seen [information blocking]. If the definition of information blocking is that the vendors have all hired Chief Information Blocking Officers who spend their nights thinking about ways to restrict information flow, I've never seen it. Find me one example.

Unfortunately, Congress, which often wields the blunt instrument of legislation, says we'll just make information blocking illegal and that will fix all the problems. No. It doesn't really help."

On the state of interoperability: "Think about meaningful use. The idea is — stage 1 — let's get folks to adopt electronic health records. The country had about a 20 percent adoption rate. Stage 2 is to get them to start exchanging data. The concept was that, by stage 3, we would be sharing data for care coordination, population health, genomics, clinical research and all the rest.

This has always been the plan. So people say, 'Wait a minute. Here we are in the middle of stage 2. Where's all the interoperability?'

It was a five-year project and we're just at the beginning of where we're supposed to be. We're on course. It's all OK. EHRs are recording data electronically. Systems are sharing data for many purposes — public health, lab results, syndromic surveillance and transitions of care. And now we get to the next step."

To read the full interview, click here.

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