Just about everyone agrees that the United States should have electronic health data standards, but federal regulators are having trouble actually setting standards and making them stick.
Doctors say they and their colleagues still use conflicting data standards, Linda Kohn, a health care director at the U.S. Government Accountability Office (GAO), writes in a letter summarizing GAO investigators' work.
Different EHR systems use different rules for classifying allergic reactions and other common conditions, and providers say they also face complicated conflicts between different states' privacy rules, doctors told GAO investigators.
Adopting and using EHR systems is expensive, and some doctors told the GAO they do not expect to exchange enough health data to make investing much time or money in EHR systems worthwhile.
Kohn says providers still have trouble with basic tasks such as matching patients with the patients' own electronic health records.
"Multiple providers and stakeholders cited situations in which several of their patients are listed with the same name and birth year and live in the same area," Kohn writes. "Two of these providers reported that patients can be matched to the wrong set of records, and that providers often need to manually match records."
GAO investigators looked at U.S. Department of Health and Human Services (HHS) EHR efforts to help Congress monitor implementation of the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.
President Obama signed the HITECH Act soon after he became president.
The law, which started to take effect while the Patient Protection and Affordable Care Act (PPACA) was still being drafted, requires HHS to improve health data standards and promote EHR use.
HHS has set up a multistage program that encourages doctors and hospitals that treat Medicare and Medicaid patients to use EHR systems.
HHS is using an EHR technology certification program to encourage software companies and their customers to adopt compatible health data standards.
In August, HHS published a set of principles for promoting an electronic health interchange.
But, in the EHR principles document, HHS failed to say what specific actions it would take, what milestones it wanted to achieve, and when it hoped to achieve each milestone, Kohn writes.