Harvard Public Health physician: MU stage 3 one step, but not enough

Although the new objectives set by CMS in its meaningful use stage 3 proposed rules move the industry forward, it is not fast enough or far enough, according to Harvard Global Health Institute Director Ashish Jha, MD.

Dr. Jha wrote in a Health Affairs blog post that meaningful use has substantially increased the medical industry's EHR use. However, simple adoption is not enough because EHRs do not improve care on their own — they must work well with physicians and nurses, he wrote.

The stage 3 rules encourages EHR implementation by simplifying the rules and making them slightly more flexible, unifying all the stages by 2018. A major aim is to make data flow more open and robust, contrasting many of the currently closed EHR systems, Dr. Jha wrote. Forcing EHRs to share their data will also push innovation by allowing third parties to built better tools to engage patients with their care, he wrote.

However, Dr. Jha concluded that the ONC should require all EHR vendors to publish their full APIs. The new rules only require the publishing of APIs as it relates to sharing information with patients, which is not enough to open up EHRs to improve function for providers, he wrote.

"This may sound like a technical issue, but it's a critically important one," Dr. Jha wrote. "If these APIs become widely available, third party vendors will build the tools that currently limit EHR utility and value. Hate the way your EHR does clinical documentation? Use the one just developed by a new vendor down the street. That kind of competition will make everyone better."

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