The natives are getting restless. In this case, the “natives” are the Stage 3 Meaningful Use critics, including the AMA and its member physicians.
The AMA recently launched BreaktheRedTape.org, which is one of the latest organized attempts to encourage federal officials to re-evaluate the MU program and fix what is not working. Providers are encouraged to post their story of how the red tape of MU regulations has impacted their practices. The concerns raised by the AMA and disgruntled physicians are all too familiar:
- EMRs reduce physician productivity
- The lack of interoperability between disparate systems hinders data exchange between providers
- EMRs are expensive to purchase and maintain. While the MU program is designed to compensate providers for their EMR use, a provider may be penalized and receive no incentives if he is using an EMR meaningfully 99.9% of the time.
- EMR usability and innovation has suffered because vendors have been forced to focus on product enhancements that address federal regulations.
Meanwhile the Senate HELP Committee continues to hear testimony about all the roadblocks to interoperability, including information blocking, privacy concerns, and technology limitations. And, on July 23, Senator Lamar Alexander (R-TN), chairman of the HELP committee, said he was recommending that HHS delay the release of the Stage 3 final rule.
Like most everyone else in healthcare IT, I’m left wondering what will ultimately happen. Will MU disappear? Will the program be re-vamped? Will we see the introduction of new standards to promote interoperability? Will more physicians drop out of the program?
In all likelihood we will see some sort of delay in the release of the Stage 3 final rule – and that will be a good thing. Arguably Stage 2 was pushed forward before the industry was ready, as demonstrated by the low attestation levels (11% of eligible providers and 42% of eligible hospitals). Stage 3 is supposed to start with an optional year in 2017 and for all participants in 2018. Unless the timeline is extended, more providers will drop out of the program and product innovation will be compromised.
A delayed timeline would give the private sector time to fix some usability issues and perhaps develop a consensus on interoperability standards – without requiring highly prescriptive government mandates. Other sectors, such as banking, air travel, and telecom, have achieved seamless data exchange with minimal government intervention; healthcare stakeholders seem similarly motivated to let the private sector take the lead in achieving its interoperability objectives.
Abandoning MU would be the wrong course of action as well, despite the program’s obvious flaws. Instead, let’s tweak what needs to be tweaked, slow things down a notch, and continue building on the program’s earlier success.
It’s time to listen to all the restless natives. Let’s push the pause button, re-evaluate, and make some adjustments. A year or two delay will ultimately improve the odds of the MU program’s long term success and also allow the market – rather than the government – to take the lead in creating the best solutions.
Michelle Ronan Noteboom
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