As the editor of FierceEMR, I spend a lot of time reviewing the Meaningful Use program--and too often find problems with it. It's not that I'm going out of my way to criticize the program or the agencies that operate it, but unfortunately they make it all too easy. Just look at some of the recent missteps:
- Stage 2 of the Meaningful Use program is too ambitious, causing the attestation numbers to drop so precipitously that the Centers for Medicare & Medicaid Services ends up scrambling to keep the program afloat, with, and among other things, a "flexibility" rule and extensions of attestation and hardship application deadlines. But it's unknown whether these last-ditch efforts will save the program.
- CMS, hoping to engage stakeholders, floats a voluntary 2015 edition certification, which ends up so vilified that it gets scrapped even before it's implemented.
- The program, so intent on the initial move from paper records to EHRs internally, gave interoperability short shrift, unduly making data exchange harder than it needed to be.
- The agencies are so afraid that the Meaningful Use program will look unsuccessful that they spin statistics in their favor, even though they know--or should know--that the data speaks for itself, which hurts the agencies' credibility.
- The program is not being run carefully enough. Lax oversight is leaving EHRs vulnerable to hackers and possibly causing the program to pay incentives to providers that didn't earn them. The Meaningful Use audit appeals process leaves much to be desired.
And on top of that there's been a mass exodus of leadership at the Office of the National Coordinator for Health IT.
The mood is so different from even just a year ago.
I'm not trying to be unduly harsh; I don't have any political agenda here. But it's easy to criticize.
Now, let's be honest and also look at the flip side: We should be thankful for the Meaningful Use program, for CMS and for ONC.
The Meaningful Use program jump started the industry into widespread use of electronic health records. The program may not have done so in the best way, in retrospect, but it's not fair to Monday morning quarterback. And EHRs, albeit imperfect, when implemented correctly can and do streamline processes, boost research and improve care.
At the same time, ONC and CMS are doing a pretty good job. They seemed to have faltered some in 2014, and should be taking more steps to correct problems, but they're trying and have made some adjustments. Let us also remember that the agencies are constrained by finite resources and limitations in the program, which ties their hands somewhat.
But most importantly, we live in a country we're we can chastise the government for its missteps. I can criticize the Meaningful Use program, CMS, ONC and even the President in this very public forum without fear of reprisal.
This is a good time to keep things in perspective. Sure, the program is currently in a bit of a mess and needs to be reassessed and modified if it's going to accomplish its goals.