Commission on Systemic Interoperability; One Year Later

A recent report from the National Alliance for Health Information Technology suggests considerable progress on many of the recommendations made by the Commission on Systemic Interoperability. The Commission was mandated by Congress as part of the Medicare Modernization act. It addressed a variety of market and regulatory issues. One theme of note was a plan for the creation of a national prescription drug "utility" that would make information available in a secure and confidential manner when it is warranted at the point of care. To many of us, such a program is an essential component of the NHIN and arguably the best "quick win" available.

• Follow this link to the report

Among the most notable achievements cited by NAHIT are:

• Exceptions to Stark and antikickback rules
• A certification process for electronic health record systems that ensures a minimum level of functionality; this process has certified many systems already
• Identifying technical standards required for more effective use of health care information

To this writer, much more has to be done. Including:

• Means of financing health care information technology in small practice settings. This writer believes it is the responsibility of providers to finance their own systems as a key element of business management in small practice. Interfaces to specific hospitals, plans, and care delivery units are essential to effective practice but such interfaces are different than creating a way to finance small practice systems and re-engineer processes. (Small retail pharmacies face similar challenges and should be included in financing and re-engineering approaches.)
• The certification process must in its next iteration require more in the way of e-prescribing standards promulgated in November. At present, one can be certified but not have to demonstrate the capability to obtain medical history and perform other e-prescribing functions that are also a part of the MMA agenda. This lag is due to timing but hopefully will be addressed.
• Identifying means of implementing standards. A part of the national agenda must be to understand how to implement standards, study them, and apply them effectively. An example of a successful approach may be the AHRQ/ CMS e-prescribing pilots