"We need more than a road map; we need action."
That sentence, excerpted from an Oct. 5 letter(3 page PDF) from AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., to the Office of the National Coordinator for Health Information Technology (ONC), sums up the Academy's response to the ONC's final version of an interoperability road map that purportedly aims to steer the nation's health information technology infrastructure into the fast lane.
The document(www.healthit.gov), titled Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap, was released for public viewing on Oct. 6.
In his letter to ONC head Karen DeSalvo, M.D., M.P.H., Wergin said the Academy shared family physicians' distress with the nation's "very slow progress" toward "truly interoperable" electronic health records (EHRs).
Wergin called for increased accountability on the part of the health IT industry that creates these products and decreased accountability for physicians who have no choice but to use the "inadequate" products.
- AAFP Board Chair Robert Wergin, M.D., recently told the Office of the National Coordinator for Health Information Technology that its final interoperability road map lacked "the necessary level of urgency" to accomplish that critical goal.
- Wergin called for increased accountability on the part of the health IT industry -- which, after all, creates the products now available to the nation's health care providers -- and decreased accountability for physicians who have no choice but to use those "inadequate" products.
- He noted that physicians must have the appropriate technology and data infrastructure at their fingertips, including system interoperability, if they are to provide efficient and effective health care to their patients and participate in new value-based payment models.
"It is critical to have appropriate technology and data infrastructure to support more efficient and effective health care delivery," said Wergin. However, data collected by the AAFP and other reliable sources show that is not currently the case.
He then ran down the list of needs.
"We need systems that provide interoperability to support continuity of care, care coordination, and the ability to switch and integrate different health IT solutions (such as EHRs) with minimal disruptions," said Wergin.
"We also need population management and patient engagement functionalities that require broad interoperability.
"These new features, as well as the old, need to be developed with user-centered design and take into account the transformed practice environment," he added.
Wergin stressed the important role of payment reform and expressed concern that the lack of interoperability and the burden of meaningful use requirements were propelling the health care system "down a path that is about to collide with the new MACRA (Medicare Access and CHIP [Children's Health Insurance Plan] Reauthorization Act) law requirements."
Primary care practices are working at capacity, said Wergin. "Every minute that physicians and their practice staff (members) spend on managing administrative complexity -- and doing the work health IT should be automating -- is precious time removed from their focus on patients," he added.
Wergin then joined a cacophony of voices around the country in calling on the ONC to delay any further implementation of meaningful use rules.
"This delay would allow for an alignment with MACRA and, more importantly, allow for all resources to be directed toward achieving greater interoperability."
Wergin argued that physicians and their patients could not wait until 2024 for an improvement in interoperability, as is outlined in the road map.
"If we want physicians and other clinicians to transform their practices and be successful in the value-based payment models established by MACRA, then we must ensure that the information technology infrastructure is capable of assisting them," he concluded.
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