While there has been plenty of grumbling about the Meaningful Use criteria for government electronic health record incentives, the Administration listened to a variety of private voices in designing those requirements. And, although the Health IT Advisory Committee arguably overestimated the industry's readiness to use EHRs in quality improvement, a New England Journal of Medicine study suggests that Meaningful Use is pushing doctors and hospitals in the right direction. That study shows that patients of physicians who used EHRs received more recommended care and had better outcomes than did the patients of doctors who relied on paper records.
Overall, the Administration--and the Office of the National Coordinator for Health IT (ONC), in particular--have bent over backward to work with the private sector. Last week, for example, ONC announced it was testing metadata standards to move the technology of health information exchange forward. ONC has enlisted the help of experts from healthcare organizations and vendors, and is housing the initiative on the wiki for its Standards & Interoperability Framework.
Similarly, ONC and private companies together developed the Direct Project protocol that allows clinicians to exchange secure messages and attachments online. A number of health information exchanges around the country are starting to use the protocol, and many vendors are incorporating it into their EHRs. Moreover, the health Internet service providers (HISPs) that will enable providers to use Direct messaging all will be private firms.
The list goes on. ONC and the Office of the U.S. Chief Technology Officer are cosponsoring a series of meetings between health IT innovators and healthcare organizations around the country. Last June, the White House created Startup Health, a strategic initiative designed to help health and wellness entrepreneurs get their companies off the ground. ONC is providing funds to 17 Beacon Communities to move health IT in new directions that will improve the quality of care. And it has sponsored contests that provide cash prizes for innovative concepts.
Perhaps the most ambitious health IT experiment that the government has launched--beyond Meaningful Use itself--is the initiative of the Department of Veterans Affairs and the Department of Defense to use an open-source community to create a new combined electronic health record for military personnel and veterans. While it's unclear how far and fast this will go, the two departments have concluded that the collaboration of many private companies can provide cutting-edge solutions more quickly and effectively than a single vendor can. This won't necessarily cost the government less than the traditional procurement process, but it should give the departments more value for their money, Peter Levin, the VA's chief technology officer, told InformationWeek Healthcare.
While the VA-DoD's open-source approach is a recognition of where technology is going, the Administration is prodding the healthcare industry to move in certain directions that it considers desirable from a public policy standpoint. The HITECH Act authorized most of these interventions, but some healthcare providers still don't want the government to tell them what to do--even if it's only a matter of carrots and sticks. Wherever you stand on that issue, however, it's clear that the Administration's primary approach to carrying out its health IT mandate is to work closely with the private sector. - Ken (@FierceHealthIT)