A report from the Government Accountability Office details five barriers to interoperability, while at the same time raising criticism by a former ONC official, who calls the GAO report "incomplete."

GAO delved into interoperability at the request of Congressional leaders who asked the watchdog to report on the status of efforts by entities other than the federal government to develop infrastructure that could lead to nationwide interoperability of health information.

"Representatives from the 18 nonfederal initiatives GAO reviewed described a variety of efforts they are undertaking to achieve or facilitate electronic health record (EHR) interoperability," GAO found, "but most of these initiatives remain works in progress."

Moreover, in its report Electronic Health Records: Nonfederal Efforts to Help Achieve Health Information Interoperability, GAO identified five stubborn barriers to interoperability.

1. Insufficiencies in health data standards
2. Variation in state privacy rules
3. Difficulty in accurately matching all the right records to the right patient
4. The costs involved in achieving the goals
5. The need for governance and trust among entities to facilitate sharing health information

[See also: 5 reasons to hit pause on Stage 3 meaningful use.]

On standards, GAO found: "Fifteen of the 18 initiatives are working to address insufficient standards needed to achieve EHR interoperability. Eighteen representatives from 7 of the 15 initiatives told us that they are developing instructions for implementing standards in ways that enhance interoperability."

Calls from Congress to pause the Meaningful Use EHR Adoption Program have become louder and more frequent, meanwhile.

Lamar Alexander, (R-Tenn.) chairman of the powerful Senate HELP Committee has repeatedly called for a delay of Stage 3 meaningful use, though the rules have already been sent to the Office of Management and Budget, for review and finalization. And just last week, more than 100 members of Congress petitioned HHS Secretary Sylvia Burwell to delay Stage 3.

[See also: Senate suggests Stage 3 MU delay and Delay Stage 3 meaningful use, senator urges again.]

Jacob Reider, MD, who served as deputy national coordinator and chief medical officer at ONC until a year ago, is now chief strategy officer at Kyron, a startup that aims to enable personalized medicine through deep analysis of medical data with advanced machine learning.

He took exception with the GAO findings and also the reporting surrounding it in an Oct. 1 tweet: @Jacobr GAO report: Incomplete research + lazy reporting propagates political fiction. Sad."