December 8, 2010 -- The federal government should be more aggressive in pushing hospitals and physicians to adopt electronic health record systems that can trade information with other providers rather than just store electronic information internally, said a report by the President's Council of Advisors on Science and Technology (PCAST).
The 91-page report recommended 24 steps that federal agencies could take to spur the adoption of interoperable systems. The proposal included a recommendation for the Office of the National Coordinator for Health Information Technology (IT) to "move more boldly to ensure that the nation has electronic health systems that are able to exchange health data in a universal manner." The group said that the ONC should tell providers that they will need to have this type of system in place by 2013 in order to get Medicare bonus payments.
David Blumenthal, the national coordinator for health IT, likened his reaction to the goals in the report to the experience of a mountain climber who scales one peak only to find that there are many more ahead before he reaches the summit. He said the council members were essentially saying, "Congrats on what you've done, but there's a whole lot more to do."
Blumenthal said he would implement the recommendations "as quickly as possible" but acknowledged there could be some difficulties in reaching the goals as his office worked through technical details that could bring surprises. Nonetheless, he called the objectives of the council "doable."
Among the other suggestions from the council were recommendations for the ONC to establish minimal technical standards for information sharing.
The group called on the Centers for Medicare and Medicaid Services (CMS) to "redirect the focus of meaningful use measures as rapidly as possible from data collection of specified lists of health measures to higher levels of data exchange and the increased use of clinical decision supports" in an effort to make sure that different computer systems can talk to each other.
The group said CMS should not wait for an upcoming report on IT modernization before beginning "to develop options for the modernization and full integration of its information systems platforms using modern technologies." The members said that by 2014 CMS should try to fully integrate its systems so that it can share valuable data within the agency and with providers.
The group also said CMS should "exercise its influence as the nation's largest health care provider to accelerate the implementation of health information exchange using tagged data elements."
The American Hospital Association said in a statement that it supports the council's goals but has some concerns.
"We support an environment where health information follows the patient so that the right information is available to the right caregiver at the right time to support the best possible care,'' the statement said. "We remain concerned, however, that there are no uniform, national mechanisms in place today to accurately match patients to their records across sites of care. That needs to happen to ensure clinical decisions based on shared records are safe and appropriate.
"In moving forward with greater health information exchange, we must balance the availability of health information to support care with appropriate safeguards on this inherently sensitive information."
The report will be published later this week in the Federal Register, and the Department of Health and Human Services is asking for public comments until Jan. 17, 2011.