AMA, others ask ONC to look past volume for measuring interoperability

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Using the volume of patient data being exchanged as the basis for interoperability measures may “hinder successful implementation” of the Medicare Access and CHIP Reauthorization Act (MACRA), according to a letter from the American Medical Association.

Along with 36 other specialty medical associations, the AMA warned the Office of the National Coordinator of Health IT (ONC) that continuing Meaningful Use (MU) interoperability requirements would limit the benefits of using electronic health records (EHRs).

“Despite claims by many health IT vendors that their products are interoperable, the vast majority only exchange static documents in a manner that satisfies minimum MU requirements,” the AMA wrote. “Many in health care view this level of exchange as little more than digital faxing. We are therefore concerned that both CMS and ONC are misinterpreting the current use of health IT as a benchmark for successful interoperability.”

The AMA letter said CMS should abandon “deficient” MU measures, rather than continuing them as proposed in the Advancing Care Information category of the new Merit-based Incentive Payment System (MIPS). It argues that if the exchange of health information is only defined by how much data is passed back and forth, EHR developers will make it their sole focus.

“There is no reason to carry over the flawed measures from Meaningful Use,” AMA President Steven Stack, MD, said in a statement. “MACRA gives us a chance to start fresh and produce metrics that enhance the wellness of patients. We are willing to work with CMS and ONC to get there.”

In an earlier letter on interoperability standards, the American Medical Informatics Association had also expressed doubts about the use of volume-based measures. Instead, AMIA urged CMS and ONC to adopt an approach to determine “if the outcomes enabled through interoperability had occurred.”

Under MACRA, ONC is required to develop interoperability standards by July 1, and achieve interoperability by 2018.