EHR Interoperability a Source of Pain and Debate in Vermont

The lack of interoperability stems from innovation outpacing standardization. Because of the lack of proper guidance from the Office of the National Coordinator for Health Information Technology, which is charged with providing specifications for health information technology (IT), and other federal agencies during the earliest phases of EHR implementation, it is likely that Vermont isn’t the only state suffering these growing pains.

For the Centers for Medicare & Medicare Services (CMS) EHR Incentive Programs, the ONC looked to the continuity of care document (CCD), which was developed by the authority for health IT interoperability standards Health Level Seven International (HL7). Under meaningful use, a certified EHR must be able to export a CCD comprising patient header information, allergies, medications, lab result, and other problems.  

Despite being pegged as the vehicle for interoperability, the CCD is criticized for not being the interoperability panacea, including the developers for the ONC-funded SMART (substitutable medical apps, reusable technologies) who are trying to enable interoperability through more commonplace forms of technology such as the application programming interface (API) beloved by app developers...