How badly will meaningful use be watered down
Since the "meaningful use" criteria defining who will get federal dollars for health IT investments were announced late last year, interest groups have been racing to their keyboards, looking for relief. (Picture from Vanderbilt University Medical Center.)
That's because while the heavy lifting on the regulations was done by committees under Dr. David Blumenthal, the National Coordinator for Health IT, the final standards will be put out by the Centers for Medicare and Medicaid Services (CMS).
The Blumenthal group is great on what should be done. CMS is all about what can be done.
The Blumenthal group is focusing right now on reducing the number of quality measures required, and says it will next focus on "philosophical" arguments. Some 25 quality measures were due to be reported starting in 2011 under the original proposal. The Blumenthal group will meet to discuss all this on Wednesday.
More worrisome are complaints from groups representing medical clinics and hospitals, which seem to indicate they want federal dollars to pay for work they have already done, and to get credit for just collecting data, not making any real use of it.
Writing at The Health Care Blog, Margaret Gur-Arie says doctors who are "too busy seeing patients" need to get their two cents in, and that the final rules need to go through a maze of state, regional and local doctors' groups if they're going to work.
The most important point in the final regs, she notes, is that the "drop dead" date for making use of technology and qualifying for 2011 cash has been pushed back, from January to October, giving hospitals and practices more time to move through RFP and purchase cycles.
All well and good, but it's those "philosophical" objections that have me worrying. There are two:
- Something for nothing -- Hospitals that spent money on health IT in the past think they should be tax money for last year's spending next year. That's not stimulus, and given the bad record of those systems in helping drive improvements, it's simply wasteful.
- Nothing will work -- Many who have seen Bush-era health IT money get wasted have concluded that health IT is worthless, and always will be worthless. The "disconnect" between policymakers and working doctors is based on the fact that past policy did not mandate doctors use data to change what they do, just collect and holds it.
For any business, installing a computer and collecting data on it means nothing. Meaning is derived from using that data to drive change in the business.
Health care is no exception. The standards put forward last month recognize this difference. They need to go through.
This post was originally published on Smartplanet.com