Hurry up and wait some more

There have been a lot of people in hurry-up-and-wait mode since the American Recovery and Reinvestment Act passed in February. They may have to wait even longer, since we're now hearing that HHS won't have a final definition of "meaningful use" until the second quarter of next year.

Still, there are plenty more who would prefer to wait even longer.

However, as FierceHealthIT noted this week, Healthcare IT News reported that the Aug. 14 meeting of the federal Health IT Policy Committee grew contentious during the Q&A portion, as many, including vendors, physicians and privacy advocates, voiced concern that the government was moving too fast--when's the last time you heard anyone say that?--in setting its 2011 criteria for winning EMR subsidies. Can a substantial number of physicians be entering electronic orders by the end of next year? Among other data points, providers would have to report hemoglobin A1c levels for diabetics enrolled in Medicare, blood pressure trends for those with hypertension and the percentage of smokers counseled about smoking cessation, according to the article.

The publication also says that doctors and hospitals that expect stimulus payments in 2011 will have to demonstrate that they were meaningful users of electronic data in 2010, even though the HIT Policy Committee isn't planning on submitting its final recommendations on quality measures to CMS until the third quarter of next year. We'll see how that goes.

Since this is a Medicare and Medicaid bonus program, CMS does indeed have the final word on the details and rules for the incentive program, which also could be a neat trick for the agency to pull off. Indeed, some seven months into the Obama presidency, there is no permanent administrator of CMS. FierceHealthIT highlighted this glaring vacancy this week, pointing to a New York Times piece on the subject. The Times said that the White House has considered quality guru Dr. Donald M. Berwick, Geisinger Health System boss Dr. Glenn D. Steele Jr. and Billings (MT) Clinic CEO Dr. Nicholas J. Wolter. A reliable source I spoke to this week indicated that he was aware of at least one other person being offered the job. The source wouldn't disclose the name, but ticked off several reasons why someone might decline the appointment, including the fact that the next CMS administrator faces a whole laundry list of unenviable tasks.

The more that the timeline gets scrunched, the more difficult that job will be. - Neil