It's time for Meaningful Use to spring into change

Has anyone else noticed the growing disconnect between EHRs and Meaningful Use?

Now that the program is fully entrenched and it's been out for more than a test spin, it's pretty clear that there are some kinks to it.  

For starters, there's the growing recognition that interoperability should have been a primary, if not the most important aspect of the program. It's more complex to impose interoperability after the fact.

Then you have the American Medical Association's lament that the program needs to be more flexible. The current "one-size-fits-all" mentality just isn't working for many physicians, especially specialists, AMA says; the "all-or-nothing" approach to attesting, it says, penalizes physicians who earn a passing grade but don't get an "A" grade.

There's also the acknowledgement that to promote continuity of care, a broader spectrum of providers should have been invited to the Meaningful Use party. Why no cake for behavioral health? Long term care?

These are just some of the reasons why so many stakeholders have called for changes in the program.

The U.S. Department of Health & Human Services and its sub-agencies may finally be starting to see the light, as well. Maybe they've realized that it's not always best to "keep the pedal to the metal." We're seeing the seeds of change in Meaningful Use. Recent examples include:

  • The HIT Policy Committee, realizing that it may have been too ambitious, scaled back its recommendations for Stage 3 of the program, eliminating eight of its 26 initial recommendations, including some that dealt with care planning, imaging and medication adherence.
  • The Health IT Policy Committee's certification/adoption work group is recommending that ONC change course on certification and instead take a "holistic" and "end-to-end" approach to certification with a goal to create a more streamlined, coordinated and timely process. It's also proposing that the scope of certification be limited to interoperability, clinical quality measures and privacy and security.  These changes may be better than CMS' "voluntary" 2015 edition of certification criteria, which no one seems to want.

Perhaps the most telling sign that it's time for Meaningful Use to evolve, however, is the changing of the guard within HHS, which could very well impact the direction of the Meaningful Use program and the focus on health IT. In January, Karen DeSalvo took over as National Coordinator for Health IT; soon we'll have a new HHS secretary.

And the trickle of departures of other HHS executives has become a flood this month. Mike Hash, director of HHS' Office of Health Reform, Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, and CMS principal deputy administrator Jonathan Blum all announced that they are leaving. Susan McAndrew, deputy director of health information privacy for HHS' Office for Civil Rights, has just retired. And we know that OCR head Leon Rodriguez is slated to move to the US. Citizen and Immigration Services sometime soon, as well.

That means that a lot of people within the agency will be shuffled around. People in their new roles will want to make their own mark.

Spring is a prime season for change, with graduations, weddings, people buying and selling homes. So why not the Meaning Use program? The time seems ripe. ONC seems willing; it's holding public hearings this week to solicit input on the direction of health IT regulation.

Let's keep our fingers crossed. - Marla (@MarlaHirsch and @FierceHealthIT)