CMS, ONC need to get beyond Groundhog Day

I hate to say it, but isn't it about time that the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT realized that they are trapped in a "Groundhog Day" time warp? In the 1993 movie of the same name, Bill Murray is condemned to repeat Feb. 2 until he finally realizes why he's stuck and then changes his ways--and his attitude--in order to move on. 

Except that we know that the movie had a happy ending. The direction of the Meaningful Use program is not so clear.

The latest Meaningful Use Stage 2 attestation figures, announced at this week's Health IT Policy Committee meeting, remain underwhelming. Although more than 500,000 providers are active registrants of the program, only 11,478 eligible professionals (EPs) and 840 eligible hospitals (EHs) have attested to Stage 2 of Meaningful Use for the 2014 reporting year.

That's less than 17 percent of EHs and 2 percent of EPs.

Moreover, the deadline for 2014 year reporting is looming. EHs have less than a month to report for 2014; EPs have only until February. This is not a lot of time. Then we're smack into 2015, with its penalties for not meeting Meaningful Use and a new 365-day reporting period kicking in. Providers are getting pretty desperate.

But you wouldn't know it from the rosy spin that CMS and ONC gave the numbers. The presenters called the data "preliminary" and waved the low numbers off, saying that most providers wait until the last minute to attest.

I also was taken aback by ONC's report on its privacy and security surveys, soon to be released in a data brief. Vaishali Patel, a senior adviser to ONC's Office of Planning, Evaluation and Analysis, related that despite some privacy and security concerns, consumer support for electronic health records and health information exchange (HIE) was "relatively high." She also reported that the consumers surveyed had no greater concerns whether the records were in electronic or paper form.  In other words, Americans think that EHRs are just as secure as paper records.

But the average American consumer doesn't know that a security breach of EHRs typically involves many more records, and that EHRs are more vulnerable to breaches than paper simply due to their nature and portability. And from the presentation slides, it appears that ONC didn't clarify that in its surveys.   

When questioned as to whether the consumers understood the third-party nature of HIEs, Patel admitted that the question asked respondents only what they thought of data sharing "by fax" vs. "computer to computer." Talk about misleading.

The agencies have done this before. They tend to cheerily report various data that they've amassed without putting it into context and skew it to their favor.

But isn't it time to stop with the charade? ONC and CMS are in a time warp, making the same mistakes, not admitting inadequacies--and not moving forward.

I'd be willing to wager that if the agencies would simply come clean and say "we're in over our heads" or "our agenda was too ambitious" or "we need help" or "we need to reconsider our direction" or anything else remotely honest, stakeholders may have a glimmer of hope and come back to the table.

After all, everyone really is on the same side here. We all want better patient care at lower costs. We want EHRs to work well. 

We need to collectively get to Feb. 3. - Marla (@MarlaHirsch and @FierceHealthIT)

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