‘Half-baked’ government intervention has stymied EHR innovation, says one economist

A doctor at a desk holding up his hand to say stop
A Cal Poly researcher says the feds need to take a hands-off approach to improve interoperability.

Nearly a decade after the HITECH Act, healthcare is still working to achieve EHR interoperability, and one researcher is laying the blame squarely at the feet of the government.

Subsidies designed to help doctors and hospitals implement EHRs have “failed miserably to improve patient-doctor relationships,” Michael L. Marlow, a professor of economics at Cal Poly, San Luis Obispo, writes in The Hill—a failure he attributes to a “half-baked plan” to computerize patient records within five years.

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Marlow argues that the subsidies failed to incentivize EHR vendors to share patient data with one another, leading to $35 billion in subsidies that amounted to government waste. He took further issue with the Office of the National Coordinator for Health IT (ONC) that mandated deadlines for EHR certification.

The decision to subsidize EHR implementation has been widely criticized. Providers and health IT associations have uniformly rebuffed the ONC’s January 2018 deadline to meet the 2015 Edition for EHR Certification, calling for deadline extensions ranging from six months to indefinitely.

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A proposed rule issued by the Centers for Medicare & Medicaid Services this week relaxed some reporting requirements tied to Meaningful Use but did not extend the deadline for EHR certification.

Rather than a heavy-handed approach to EHR oversight, Marlow advocates for the government to back off almost entirely—merely setting minimum standards for what data should be collected and ensuring that data can be shared across the care continuum.

“A farsighted government allows technology to emerge rather than dictate an evolving technology that promises to improve our healthcare system,” he writes. “Markets then have a fighting chance at innovating EHR systems that improve public health and lower healthcare costs."