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My Take on “Meaningful Use”

D. Kellus Pruitt DDS

Recently, lawmakers complained that the federal criteria for “meaningful use” of eHRs – usage required before providers who risk purchasing electronic health record systems can be reimbursed – aren’t strict enough to justify the billions of dollars in incentive payments that the government promised physicians and hospitals. Matthew DoBias, writing for ModernHealthcare, quoted Rep. Wally Herger (Calif.) – the senior Republican on the Ways and Means Committee’s health subcommittee – who said:

“The new HIT regulations are a step in the right direction and should put Medicare on a path to improved quality and efficiency. However; by watering down the final regulations, we have missed an opportunity to advance healthcare delivery and ensure wise use of taxpayer money.”

http://www.modernhealthcare.com/article/20100721/NEWS/100729995/1153

Rep. Wally Herger

“Improved quality” you say, Rep. Herger? That proves that politicians like Herger will say whatever it takes to get elected, even if it’s transparently misleading. Herger’s confident claim of improved quality of care from using eHRs is typical of Washington even though quality claims are widely disputed in most medical circles. And if eHRs were as efficient as Herger and his campaign donor’s claim, then the billions of dollars in incentive payments that have already been billed to our grandchildren wouldn’t be wasted to bribe physicians to purchase eHR systems that are too lousy to move off the shelves. If HIT stakeholders’ products offered value for Americans in the land of the free, they would sell for natural reasons of consumer demand and wouldn’t require a government mandate and Herger’s deception. Besides, what does any politician know about “wise use of taxpayer money” even outside of the medical field, Mr. Herger?

[picapp align=”none” wrap=”false” link=”term=doctor+computer&iid=107036″ src=”http://view3.picapp.com/pictures.photo/image/107036/medical-professional-using/medical-professional-using.jpg?size=500&imageId=107036″ width=”337″ height=”506″ /]

The Criteria

The criteria for meaningful use have been cut down to 15 issues allegedly because demanding all 25 risked improving care and saving money far too ambitiously. Tony Trenkle, director of the Office of E-Health Standards and Services at CMS, puts his special spin to the “watering down” of requirements. He is quoted in an article by Emily Long in NextGov:

“We set the bar where we felt it was appropriate and also signaled for future stages that we would be setting the bar much higher, We’re going along with ways we can modify to reflect real-life experiences we hit once the program begins.”

Why didn’t Trenkle just say, “We at CMS are making this sucker up as we go”?

http://www.nextgov.com/nextgov/ng_20100720_9874.php?oref=topnews

Dr. David Blumenthal

Dr. David Blumenthal, the national coordinator for health IT, has given up apologizing for bankrupt ideas like the CMS’s criteria for “meaningful use” of electronic health records – as if they made sense. They don’t, and Blumenthal must know that the clicking-for-cash busywork plan he inherited is a waste of time and money. Otherwise, the AMA wouldn’t be complaining.

(See “AMA Weighs in on ‘Meaningful Use’ Requirements For E-Records” – Wall Street Journal Blog)

http://blogs.wsj.com/health/2010/07/21/ama-weighs-in-on-meaningful-use-requirements-for-e-records/  

Surely Dr. Blumenthal recognizes that naive lawmakers like Rep. Wally Herger are foolishly demanding unwanted and dangerous micromanagement of healthcare, not in the interest of patients’ welfare, but for political power. (Do Americans really want Wally Herger from California regulating healthcare?) Rather than attempting to sell systems to doctors based on disingenuous claims of unproven value, Blumenthal chose to punt. All he could offer was a lame appeal to pride: “Much more important than incentives will be a professional sense of obligation,” (Emily Long, NextGov, ibid).

The Oath

Doesn’t the Hippocratic Oath, as well as business survival trump the dangerous nonsense Dr. Blumenthal calls “professional obligations”? As if to emphasize that point, just hours ago, some relevant news was posted concerning the danger of eHRs: “A Massachusetts hospital is under scrutiny after hundreds of thousands of patient and employee records went missing earlier this year. The missing files underscore the problems health care providers face when balancing patient privacy and the need to store massive amounts of data, especially as new federal rules for electronic health records come into play.” (See “Massachusetts Hospital Reports 800,000 Personal Records Missing” by Brian T. Horowitz for eWeek, 7/21/10).

http://www.eweek.com/c/a/Health-Care-IT/Massachusetts-Hospital-Reports-800000-Personal-Records-Missing-638660/ 

Assessment

How does risking such harm to patients rise to the level of a “professional obligation”? I think Dr. Blumenthal might be confusing professionalism with patriotism. They are both traditional, flexible buzzwords that start with the letter “P” and are often used for just about any bureaucratic chore – even so far as to prove diametrically opposing views.

Conclusion

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Filed under: Health Law & Policy, Information Technology, Op-Editorials, Pruitt's Platform | Tagged: ADA, AMA, Brian T. Horowitz, CMS, David Blumenthal, EHRs, EMRs, Office of E-Health Standards and Services, Rep. Wally Herger, Tony Trenkle | 3 Comments »