Senators Question Meaningful Use EHR Investment

Six Republican Senators have released a report arguing that there’s no evidence the $32 billion spent on Meaningful Use is delivering the benefits it was designed to offer.

The report, entitled “Reboot: Re-Examining The Strategies Needed to Successfully Adopt Health IT,” was released by Senators Thune, Alexander, Roberts, Burr, Coburn and Enzi. In the report, these Senators dig into the implementation of Meaningful Use and critiquing how the money’s being spent.

The Senators’ concerns are as follows:

* Interoperability:  They argue that HITECH is not doing enough to promote interoperability.  The Senators say that incentive payments are being doled out without clear evidence that providers can connect with one another.

* Cost savings:
 Health IT has been promoted as a tool for taking costs out of the health system, and, the Senators concede, is projected by the CBO to save Medicare and Medicaid $12.5 billion through 2019.  However, they note that some reports state that health IT may have accelerated ordering of unnecessary care as well as increased billing per procedure.

* Oversight:
 The Senators cite reports from the HHS Inspector General and the GAO which seem to suggest that the Administration hasn’t done enough to prevent fraud and waste in the Meaningful Use program.

* Security:
  The report argues that Meaningful Use standards don’t do enough to secure private patient data; they cite reports from the HHS OIG claiming that Medicare and ONCHIT are “lax”  in this area.

* Sustainability:  
When the Meaningful Use money runs out, will providers still be able to keep their health IT equipment running? In the report, the Senators suggest that the ongoing cost of maintaining EMRs and other health IT may be too much to bear, especially for small practices, when the money runs out.

As with most reports of this kind, I’d argue that there’s some truth mixed in with some partisan posturing. For example, I can see where Senatorial observers might be frustrated with the pace of interoperability efforts. On the other hand, I think the sustainability argument may be a straw horse;  my gut tells me that once a practice or hospital has spent years implementing an EMR, they’re not going to drop it like a hot potato when the incentives stop coming.

What do you think of the Senators’ critique?

About the author

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

4 Comments

  • I think they’ve taken every rumor and story they’ve heard about weaknesses in the MU programs and turned them into a political football without actually coming up with viable suggested fixes. There are lots of issues out there, but I don’t see any actual desire here to solve them. The funny thing – most of us probably agree with at least some of their points. Many of us have commented on the poor progress of interconnecting and sharing health records. A few of us have also commented on the wasteful and poor quality ONC training program as well.

  • Although the report might have some political agenda, but I totally agree with its findings. I’ve been promoting HIT for more than a decade in the US and outside. I have managed and participated in significant automation projects and initiatives but without real tangible outcomes. Cost of healthcare is rising and you still don’t get your EMR/EHR readily available if you did the mistake of seeing a doctor in “another” hospital or health system, although they are all having big tag HIT vendor systems.

    In 1998-1999 the “To Err Is Human” report found that medical errors are causing ~ 98,000 causalities in the US yearly. Is there a new statistic to show that results have improved due to HIT adoption? Please excuse my ignorance because I haven’t heard of one!

  • Medical Errors statistics are not only from critical care hospital reporting. I suspect majority of errors would be to patients that are residents of rehabs and skilled nursing facilities who come and go through emergency departments for symptom changes. If there was a legal line drawn after patients are discharged from critical care so health care could be done without drugs in none critical settings, I believe the medical error statistics would fall and patient recovery would be assured and healthcare costs would also fall.

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