Health IT actions of new Congress must be meaningful

Well, that was fast.

Only days into the new legislative session, and lawmakers already are swinging at the Meaningful Use program. The Flexibility in Health IT Reporting (FLEX-IT) Act to shorten the Meaningful Use attestation period in 2015 from 365 to 90 days has already been reintroduced with bipartisan support. Co-sponsor Rep. Renee Ellmers (R-N.C.), who first introduced the bill in 2014, is calling the current attestation numbers "dreadful;" co-sponsor Rep. Ron Kind (D-Wis.) says that the existing full-year reporting window is "unrealistic."

At the same time, three prominent Republican senators have asked the Government Accountability Office (GAO) to review health information exchanges supported by the Office of the National Coordinator for Health IT. While those HIEs received almost $600 million in federal grant money, many have struggled with sustainability. Some have even failed and shut down completely.

Neither of these developments are surprising. Policy makers, providers and others have been clamoring for relief from full-year reporting in 2015, claiming that if 2014's attestation numbers are any indication, a full year reporting requirement will simply be unreachable for many providers, setting them up to fail and jeopardizing the future of the Meaningful Use program.

It's also no wonder that the HIE issue cropped up so early on the Congressional radar screen. A recent RAND report said that the HIEs were still "experiments" that may not deliver as promised; a study from the University of Chicago found that HIE support and success was mixed at best.

Each position does have another side, of course.  

HHS wants to keep the Meaningful Use program energized and its momentum going, the "pedal to the metal." Some providers have successfully attested to Stage 2 of Meaningful Use and HHS claims that the number of eligible providers attesting is better than first reported. HHS has already made several compromises; if it capitulates on the reporting, too, providers may not try as hard to comply.

And arguably, some of the HIEs' troubles are not their fault. They were not provided much in the way of governance, which resulted in different business models and possibly poor decision-making. They were tasked with providing interoperability before interoperability was the priority it is now, so providers didn't sign on. Some vendors have made it hard to achieve interoperability. Patients are leery about how well HIEs will protect their health information. Health IT still doesn't support data exchange well. Just throwing money at a project without better support does not guarantee success.

But clearly these are pressing issues that really call out for investigation and change. Congress is right to step in.

The real question going forward will be what happens next? The FLEX-IT bill would need to be enacted quickly if it's to provide any relief to providers. Can a brand new Congress accomplish that?

What will the Senate do with the GAO information, which most likely will not turn up any surprises?

And what will Congress do after it deals with this low hanging fruit? Will lawmakers on both sides of the aisle work together to improve EHRs, health IT and the Meaningful Use program?

It is my hope that the new Congress will take the opportunity to make additional and meaningful improvements. Let's see lawmakers tackle the issues of accountability for EHR-related adverse patient safety events; EHR usability and functionality inadequacies; the best balance between regulatory requirements and market forces to create change; and better ways to keep electronic records safe.   

Please, Congress, whatever you do, don't just engage in petty political posturing and partisanship. Be leaders. You also have an obligation to be Meaningful. - Marla (@MarlaHirsch and @FierceHealthIT)

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