Physicians and hospital executives have raised concerns that electronic health record systems are unable to share patient data with systems developed by competing vendors, the New York Times' "Business Day" reports (Creswell, "Business Day," New York Times, 9/30).

Background

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (iHealthBeat, 9/19).

According to "Business Day," a portion of the meaningful use requirements mandates that providers are able to share EHR data with other providers. Providers with systems that are not interoperable could eventually face Medicare penalties under the program.

Barriers to Data Exchange

Providers have said that certain EHR systems were built to impede the ability to share patient data, contrary to the meaningful use program's requirements. For example, some providers have pinpointed Epic's EHR systems as being deliberately created so they cannot share data with competing EHR systems.

Raghuvir Gelot, a physician at a North Carolina-based practice that has struggled to share patient data on its Epic system with outside providers, said, "The systems can't communicate, and that becomes my problem because I cannot send what is required and I'm going to have a 1% penalty from Medicare." He added that the federal government is "asking [him] to do something [he] can't control."

In addition, providers have noted that when systems can share data, they often require significant upfront charges to connect or recurring fees. The charges can inhibit smaller practices from connecting with larger, more technologically savvy and financially sound health systems.

According to "Business Day," federal regulators so far have failed to respond to the interoperability issue. A spokesperson for the Office of the National Coordinator for Health IT in an emailed statement said that stakeholders must "come together and agree on policy-related issues like who can access information and for what purpose." The spokesperson added that interoperability is a "top priority" and noted the office recently released a 10-year vision and agenda on the issue ("Business Day," New York Times, 9/30).