Doctors face conflicting standards of EHRs.(Practice Trends)

BOSTON -- Interoperability is key to the success of electronic health records, but there are barriers to sharing data between systems, said David Brailer, M.D., national coordinator for health information technology.

The major challenges include standards harmonization, unclear data control policies, a lack of uniform security practices, the inability to ensure that products perform as advertised, and the lack of a business model around interoperability, he said.

"At the very basis of this--kind of the DNA of the interoperable electronic health record--is the emergence of harmonized standards," Dr. Brailer said at a congress sponsored by the American Medical Informatics Association.

Many organizations are involved in developing and approving standards, but there isn't a process for harmonizing two conflicting standards, according to Dr. Brailer.

In addition, there is no unified maintenance or release schedule for standards so that the industry can know what's coming and build investment plans around it.

Further, there is no means of providing input into the standards process, he said. For example, there isn't a mechanism for taking a problem and distilling that into requirements that could be used by organizations that develop standards.

"Problems don't come well packaged into a standard," Dr. Brailer said.