Meaningful Use is not an overnight process
Last week, four members of Congress sent a letter to U.S. Department of Health & Human Services Secretary Kathleen Sebelius calling for a freeze on Meaningful Use incentives to providers. In their letter, Reps. Dave Camp (R-Mich.), Fred Upton (R-Mich.), Wally Herger (R-Calif.) and Joe Pitts (R-Pa.) called the program a inefficient and said it "squanders taxpayer dollars" while doing "little, if anything, to improve outcomes for Medicare."
I'm not sure I agree with those viewpoints, but can understand why they were raised at a time when every cent of government spending is under the microscope.
However, it appears as if the Congressmen want to see tomorrow's results yesterday--and if they don't get what they want they'll take their ball and go home. They want to see interoperability between all electronic health record systems now, despite the fact that the final rule for Stage 1 was only released a little more than two years ago. To that end, they call current interoperability requirements unveiled in Stage 2, just announced in August, "insufficient."
In a recent conversation with John Halamka, CIO of Beth Israel Deaconess Medical Center and co-chair of the HIT Standards Committee, he compared the situation to a child's journey into adolescence and on to adulthood.
"We are on a journey, and that journey over the last couple of years has been very, very rapid," he said. "Let's say that we, as an industry, are 3-year-olds. Then we just got that letter that says, 'well, how come you're not voting, driving and running marathons?' Well, we're 3 years old. We're going to be there soon, but we still have some growing to do."
Halamka added that in his opinion, the healthcare technology industry has grown more over the past two years than it had in the two decades before that. He said that interoperability now is in "everyone's psyche," as well as in the Meaningful Use requirements.
"It's very frustrating to me that we have 474 pages of detailed standards and regulations that are part of Meaningful Use Stage 2, that include all the content, vocabulary and transport standards needed to ensure interoperability, and a CMS rule that requires implementation before stimulus payments flow for Stage 2, and someone writes a letter suggesting there are no standards," Halamka said. "You just scratch your head and say 'I'm more than happy to go through the 474 pages of regulation if you have a question.'"
I agree with Halamka. While there's nothing wrong with being ambitious, the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT took into account the views of multiple stakeholders, many of whom were providers limited by resource issues. They looked to balance the need to grow technologically with the limitations of those providers.