HIT editor: Soften 'meaningful use' until there's more evidence EHRs are safe

Conventional wisdom holds that the Health Information Technology for Economic and Clinical Health (HITECH) Act was one of the few parts of the American Recovery and Reinvestment Act that was widely accepted. ARRA, the $787 billion stimulus bill, passed both houses of Congress along strict party lines, though there was strong bipartisan support for the HITECH provisions.

Anthony Guerra, founder and editor of HealthSystemCIO.com and former longtime editor of Healthcare Informatics, challenges that notion by arguing that the legislation is a solution in search of the right problem and that the Office of the National Coordinator for Health Information Technology may not be the best entity to lead implementation efforts. "In my opinion, ONC can't be relied on to objectively evaluate and respond to growing concerns that electronic health records, in their current state of sophistication, bring with them as many patient safety risks as improvements," Guerra writes.

The way ARRA was written, according to Guerra, is "irresponsible" in terms of letting the nation's No. 1 cheerleader for EHRs evaluate the safety of EHR systems while scientific evidence is scant. "How can the agency legislatively tasked with forcing EHR and computerized physician order entry systems into the nation's healthcare system turn around and say it now appears those systems are actually dangerous?" he wonders.

"Rather than commissioning studies on EHR safety before it essentially made them a federal requirement, Congress took the word of powerful health IT lobbying groups and stuffed the politically palatable HITECH provision into the bloated American Recovery and Reinvestment Act spending frenzy. Only now do we see the industry starting the kinds of studies that will reveal whether EHRs are really ready for mainstream use. And even if they're found safe in the abstract, there's no way they can be safely deployed under the HITECH timelines."

The only responsible path to take, according to Guerra, is to make sure the bar for meaningful use is "dramatically lowered" until there is more empirical evidence that EHRs do more good than harm when deployed on a wide scale.

For more:
- read Guerra's InformationWeek piece

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