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    There needs to be accountability for the lack of interoperability


    However, in a section entitled “Where Knowledge of Information Blocking is Limited and How to Resolve,” it states: “ONC also lacks access to the kind of detailed price and cost data, contractual language, technical documentation and other evidence necessary to objectively determine whether conduct meets the definition and criteria for information blocking established in section II of this report.” Really! If EHRs from day one were to be interoperable, why should one cent above acquisition, implementation and maintenance costs be allowed for transferring information (interoperability)?


    SPECIAL REPORT: 2017 EHR Report Card results


    It would appear that the ONC needs to put more teeth into its recommendations. Since 2005, there have been 10 directors of the ONC (3 interim and 7 permanent). Most of these have been physicians. Maybe to get more bite into their enforcement the next one should be an orthodontist.

    In conclusion, why have physicians been assessed financial penalties for not attesting to meaningful use and yet the IT industry gets a pass? Interoperability is not an example of MEANINGFUL USE. It is, in every sense of the word, MEANINGFUL PROGRAMMING.

    Yes, the responsibility or lack thereof needs to fall directly in the lap of the IT industry. They should not be allowed to charge one cent for transferring information and any attempt to do so should elicit a financial penalty. Perhaps these EHR vendors could simply tweak the mother board, because with the EHR, they have certainly hit the mother lode.



    [1] Hillestad R, Bigelow J, Bower A,Girosi F, Meili R, Scoville R and Taylor R. Can Electronic Medical Records Systems Transform Health Care? Potential Health Benefit Savings and Costs. Health Aff. September 2005 Vol. 24 No. 5 1103-1117

    [2] Adler-Milstein J, Pfeifer E. Information Blocking:  Is It Occurring and What Policy Strategies Can Address It? The Milbank Quarterly. Vol. 95, Issue 1, March 2017, p 117-135

    [3] CCHIT Certification – What Does It Require. Mycourses.med.harvard.edu/ec_res/nt/930820C0-27CB-4080-92CA-C5C152738BD9/cchit.pdf

    [4] Gadkak, S. Avoiding the 2015 Medicare HER Incentive Program Penalty. bulletin.facs.org/2014/06/avoiding-the-2015-medicare-ehr-incentive-program-penalty/

    [5] Office of the National Coordinator for Health Information Technology. Report to Congress: Report on Health Information Blocking. Washington, DC: Department of Health and Human Services; April 2015 https://www.healthit.gov/sites/default/files/reports/info_blocking_04091...

    Keith Aldinger, MD
    Dr. Aldinger is an internist who practices in Houston, Texas.

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    • [email protected]
      Doctor Keith, right on the point; we have been using an EMR since 2000; it was developed by my wife, an internist; we have had 6000 patients on it for years; it is slick, fast, disease management based, and user friendly; our transcription service ended two weeks after we started the software called Isprit; the problem is certification and interoperability; the "big guys" pushed for expensive certification to crowd out the little guys; each vender program is proprietary and "secret" so therefore, will not allow for "talking" between the software programs; how right you are in stating we physicians suffer the wrath of the government while the software companies get away with non compliance; we are done with "meaningless use", anyways, and have gone to Direct Primary Care , free of the curses and reprimands of the government and insurance companies; we work for our patients now and no one else; great article, good luck, [email protected]

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