Roadmap Milestones for a Supportive Payment and Regulatory Environment and Outcomes

CMS will administer 50 percent of all Medicare payments to providers through alternative payment models that reward quality and value by the end of 2018.

Individuals regularly access and contribute to their longitudinal electronic health information via health IT, send and receive that information through a variety of emerging technologies, and use that information to manage their health and participate in shared decision making with their care, support, and service teams.

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Providers routinely and proactively seek outside information about individuals and can use it to coordinate care.

Public and private stakeholders report on progress toward interop­erable exchange, including identifying barriers to interoperability, lessons learned, and impacts of interoperability on health outcomes and costs.

incentives, and keeping the patient at the center of our work and efforts, secure and efficient interoperability is certainly within reach.


In addition to interoperability concerns, clinicians often express frustration with the usability of EHR systems and other clinical information systems. In fact, 55 percent of physicians reported that it was difficult or very difficult to use. Common frustrations include confusing displays, iconography that lacks consistency and intuitive meaning, and the feeling that systems do not support clinicians’ cognitive workflow or inhibit them from easily drawing insights or conclusions from the data. Similarly, physicians who participated in a Rand study (Friedberg et al., 2013) felt that EHR data entry was time-con­suming, interfered with face-to-face patient care, and was overall inefficient. They also reported that inability to exchange health information and the degradation of clinical documentation were of concern. Others argue that poor usability of EHR systems not only contributes to clinician frustration but also can lead to errors and patient safety concerns.

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