Playing Devil's advocate with HITECH

I had an interesting conversation recently with Pam McNutt, the CIO of Dallas-based Methodist Health System, regarding the College of Healthcare Information Management Executives' Meaningful Use readiness survey. While the survey conveyed a sense of optimism about meeting Stage 1 expectations--with more than 90 percent of respondents indicating that their organizations likely would qualify for attached stimulus funding--McNutt's tone was anything but positive for the program overall.

A CHIME fellow, McNutt's concerns focus on what she calls the "prescriptive nature" of the Healthcare Information Technology for Economic and Clinical Health (HITECH) Act, as well as HITECH's inability to morph out of a "developing" stage. She believes that while EMRs are essential, government intervention isn't.

The essential mandate to install EMRs "is causing people to spend a lot of money [and is] accelerating our plans dramatically," McNutt said.

"Year 1 [for collecting incentives] is about to slip out of most people's hands, and I think the fact that it's a developing program--a program that never seems to mature or have a clear path--is the problem," she said. "There's too much complexity."

McNutt also criticizes the timing of Stage 2.

"The final specifications for Stage 2 likely won't be released until May 2012, but people who do qualify this year for Meaningful Use would have to be 100 percent up on Stage 2 requirements by Oct. 1, 2012," she said. "For someone to be 100 percent compliant for a whole year, starting Oct. 1 is just not even doable."

McNutt's pessimism/realism (take your pick) is intriguing, considering that last October, her organization was already in a "pretty good position" to capture some of the incentive dollars. After all, her organization doesn't have nearly as much to worry about as, say, a small practice with less access to resources to make meeting Meaningful Use requirements a reality.

Perhaps that's why we should be listen to people like her more closely--ahead-of-the-curve CIOs who aren't too hopeful about HITECH's success.

I'm not advocating scrapping HITECH; I think it's good to encourage innovation, especially when that innovation clearly is necessary to improve the quality of healthcare. But when an executive with an abundance of resources at her fingertips continues to argue against a program that her organization likely will always be able to keep pace with, I will give that person the benefit of the doubt. - Dan

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