She said that they expect to grow their exchange by 30 percent in 2013, roll out a newer platform with more compliant standards. But she also recommended that the government has a role, a mandate for the use of exchange standards, such as LOINC for laboratory diagnosis and hospital systems to generate a “just-admitted notice,” by a certain date, because “it’s happening too slowly.”

John Blair III, MD, CEO of MedAllies and president of Taconic IPA, described how New York’s Hudson Valley is on parallel transformation paths, moving practices to patient-centered medical homes and expanding that to neighborhoods and, secondly, the use of Direct protocols for interoperability.

Its Direct initiative has just graduated from a pilot program to a full offering last week on the Statewide Health Information Network of New York, he said.

Demand and interest is growing not only from practices but hospitals “driven by the 30-day re-admission penalties, ACOs and other care coordination projects in the region,” Blair said.

Vendors are ready for the technical integration for meaningful use stage 2. However, “we have discovered that the user interface within the EHR vendor technology currently does not anticipate full clinical interoperability around transitions of care,” he said.

Intersystem interoperability has not been available in the market, and provider adoption of EHRs was previously not at the level where they would rely on it as a communication tool. Now, the EHR is becoming the access point for many different types of networks.

To drive interoperability, “it comes down to relevance to the providers. If the provider honestly believes these enhancements will improve care and efficiency — and particularly if they are indirectly tied to increased reimbursements for improved healthcare value — interoperability will advance rapidly,” Blair said. “If the providers do not believe this, nothing else we do here will make much of a difference in the long run.