Despite the relaxation of the proposed meaningful use criteria for the adoption of EHRs and EMRs, critics claim that the final rule is still too stringent and the rushed timeline will doom the whole transformation to a fully electronic healthcare delivery system. Politics aside, the critiques are actually a good thing.
David Blumenthal, MD, head of the Office of the National Coordinator for Health IT, is a smart man. His predecessor, David Brailer, MD, praised him, saying he has been doing a "fantastic job" and has "deep policy capabilities." Brailer praised the proposed criteria back in January, saying that they felt right and were conceived by the "hand of thoughtful policy." He said the challenges were reaching the inevitable health IT adoption with the least disruption for healthcare providers. He also said that government policymakers are tasked with determining how to get there faster.
The current criticism says that the mad dash will just create a huge train wreck and ruin the whole healthcare system. The big dilemma for ONC was striking the right balance with the final ruling. Do you risk relaxing the criteria to the point where they are so watered down that the industry drags its feet another dozen years before any transformation occurs because there's no rush to do so? Or do you impose set-in-stone incentives and penalties, and make providers understand that adopting EHRs is part of the cost of doing business as well as the part of the medical profession?
ONC weighed both extremes and found a middle ground. This is not to say that this middle ground is easy for many hospitals - both who have not implemented EHRs or EMRs and those who have - to achieve. They have a lot of catching up to do.
But ONC didn't create this environment without a good infrastructure for those who are ill prepared as of this moment to meet meaningful use. Releasing any kind of ruling without some help and resources is an exercise in futility. But ONC didn't do that.
The criticism doesn't mention the support system that ONC created with the component programs such as the regional extension centers and beacon communities. There is more to the whole concept of health IT adoption than just the meaningful use criteria and the incentives and penalties.
Photo by David Paul Ohmer courtesy of Creative Commons license.
