Would a 'roll back' of ONC's strategic plan be good for health IT?

The National Center for Policy Analysis (NCPA) certainly didn't pull any punches in its comments on the Office of the National Coordinator for Health IT's updated strategic plan.

Unlike some commenters on the plan, who for the most part deferred to ONC, NCPA, known to favor private free market forces rather than government regulation, came out strongly against it.

NCPA didn't actually have a problem with the goals of the plan. Rather, its issue is that the federal government shouldn't be leading the brigade.

The organization said that the federal government, as "chief financier, certifier and regulator" of health IT, had rather botched the job, and that the plan should "roll back" and let market forces take over.

The NCPA commentary lambastes the Meaningful Use program as "expensive, unproductive, and potentially harmful." It says that the Centers for Medicare & Medicaid Services has pretty much plowed through the billions with which it was provided to spur Meaningful Use of EHRs with not enough to show for it, that adoption targets aren't being met. NCPA also says that providers can't meet the requirements of the higher stages and are dropping out.

It tells the government to keep out of the way "as much as possible" adding that that federal efforts "perverted the natural adoption of EHRs." 

NCPA even suggests that "[t]he federal government should step aside so that HIT can evolve the way smartphones have, and allow entrepreneurial EHR vendors a fair shot at displacing the dominant incumbents ... The billions of dollars in capital being invested in HIT must be allowed to find their own course to success."

Clearly, the NCPA has a bias. But its viewpoint on ONC's strategic plan does raise serious questions about what role the federal government should have in shaping the direction of health IT. No doubt others share at least some of these views, and that's understandable. There have been a lot of issues with the Meaningful Use program and mistakes have been made.

Can the industry revert to market forces only? ONC's draft strategic plan clearly indicates that the federal government intends to take the lead role going forward. Should it not? Should the government have a more balanced approach, a somewhat greater role than what NCPA is advocating but less than is contemplated by the plan?

Or, should the government have an even bigger role, since sometimes market forces alone don't work very well?

And who should choose?

A roll back would be a serious change in course with long term consequences, and one that cannot be viewed lightly.

Health IT needs evolution, not revolution or government overthrow. But evolution can take many different forms. It's really health IT's strategic plan.   

This is a draft document, and ONC has invited comments on it. There's still some time to weigh in. Please consider doing so.  - Marla (@MarlaHirsch and @FierceHealthIT)

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