Let's use Meaningful Use criticisms to help shape the program

It so happens that I was in-flight on the first day of  my vacation on the day that four House members sent a letter to U.S. Department of Health & Human Services Secretary Kathleen Sebelius urging her to "change the course of direction of the Meaningful Use incentive program" and  "immediately suspend" incentive payments "until your agency promulgates universal interoperable standards."

Wow. This was not what I expected to be greeting me when I returned (the HIPAA mega rule, perhaps. My luck sometimes runs that way). Did anyone anticipate that letter?

Of course the letter has generated some response. There have been quite a few articles, as well as stakeholders, that have variously defended the program, as well as others that have agreed with the Congressmen. National Coordinator for Health IT Farzad Mostashari this week even said that the Health IT Policy Committee would look into the situation and offer recommendations.

What struck me about the letter, though, was its tone and language. Certainly, arguments can be made that the letter, written by four Republicans merely one month before the Presidential election, is rather partisan in nature. We all know that this election is bitter.

But the letter seems more strident and less civil than it should be.

For instance, the congressmen tell Sebelius that  the program is "your EHR incentive program," even though Congress, not HHS, created it. They tell her to change the course of direction of the program, even though they know that the agency doesn't have that power.

The congressmen say that we're no closer to interoperability in the past four years, in spite of the program. But the recent successes of several health information exchanges have shown otherwise. The congressmen also call Meaningful Use Stage 2 "weak" and lacking in standards. Did they submit comments detailing their concerns to HHS during the comment period on the proposed rule?

Even former President George W. Bush, who called for interoperable EHRs in 2004, granted the industry 10 years to meet that goal. It didn't happen under his watch, but the letter's authors seem to have glossed over that point.    

Unfortunately, when one uses rhetoric, often the message itself gets ignored. And there is some truth to what the congressmen are saying. The Meaningful Use program and the EHR industry are not without their flaws. Those in the industry know, perhaps better than those in Congress, what they are.

So perhaps the letter can serve as an opportunity to objectively review the program and get involved in shaping it. For instance, each of us can submit comments on proposed regulations--and the rules for Stage 3 will be upon us before you know it.

And there are other ways to speak up. The Office of the National Coordinator for Health IT is looking for more members for its HIT Standards and Policy committees. That's a great opportunity to leave a mark on the program.

These ONC virtual meetings are also open to the public. This is one area in the government that we individuals get a chance to be heard.

It's a little like voting. Those who don't get involved and vote really don't have standing to complain about the outcome. - Marla