EHR Business Environment Must Change to Achieve Interoperability

The main challenges for the nation’s health IT interoperability are not technical but business related. That’s the word from former National Coordinators for Health IT speaking in a panel session on Tuesday at ONC’s Annual Meeting in Washington. Farzad Mostashari, M.D., former National Coordinator for HIT and currently CEO of start-up Aledade which partners with independent primary care physicians, warned that business practices among some electronic health records vendors are inhibiting the sharing of health information by restricting information exchange with users of other EHR products.

“My practices—I’m working with small practices—can’t get their own data out and it’s not because of the technical standards. It’s because of the business practices,” said Mostashari. “I think it’s fantastic to create a value-based payment environment where the providers are incentivized to be able to use that clinical data that we’re now collecting and to take it out and have third party applications do analytics and all this great stuff. But, the vendors don’t have the same incentives as the providers do.”

Mostashari described the current EHR vendor business environment as a “market failure” given that these companies don’t reflect the desires of their customers. “It’s better for the vendors, frankly, if they get paid for every interface,” he asserted. “Standards were going to reduce the cost of interfacing. Will they reduce the price is another question. I still have my practices paying $10,000 for a C-CDA interface.”...