Four congressmen have thrown what could be a monkey wrench into the rollout of Meaningful Use Stage 2 regulations, arguing that Meaningful Use rules are weak and ineffective and that MU incentives have gone awry.
The four have written a letter to HHS head Kathleen Sebelius to recommend that until MU Stage 2 rules require “comprehensive interoperability,” and hospitals can prove they’re capable of exchanging data, the agency shouldn’t hand out incentive payments.
In the letter, the congressmen somewhat spitefully quote the recent piece from The New York Times which suggests that EMRs are raising costs by encouraging upcoding. “Perhaps not surprisingly, your EHR incentive program appears to be doing more harm than good,” the letter says. (Oh, snap!)
What do the congressmen want? A) To see CMS suspend all incentive payments until “universal interoperable standards” are promulgated, B) to require higher level of performance from Meaningful Users (upping percentages of, for example, transfers that need to be done electronically) and C) to see HHS “take steps to eliminate the subsidization of business practices that block the exchange of information between providers.”
Of course, the health IT leaders of the world are aghast. HIMSS, for example, has already issued a statement opposing the incentive payment halt.
But there is a nuanced conversation to be had here. While I admit I’ve ridiculed the tone of the congressional letter a bit, I think there’s some merit in the complaints. Interestingly enough, the most substantial complaint (letter “C”) in the missive is discussed the least in the text.
Let’s think about what John rightly calls “Jabba the Hutt” EMR vendors. What incentive do they have to change their business practices and make their products interoperable if the only threat to their business is academic discussions about Blue Buttons, The Direct Project and 17 flavors of HL7?
No, my friends, while I disliked the nasty, hectoring tone of the letter, I think we should take the authors’ objections seriously. We are at an interoperability crossroads and there’s no immediate end in sight.