Meaningful use to be phased in

The big headline coming out of yesterday's Health Information Technology Policy Committee meeting in Washington is that the definition of "meaningful use," under which gear becomes eligible for HITECH stimulus money, will be phased-in.

The big headline coming out of yesterday's Health Information Technology Policy Committee meeting in Washington is that the definition of "meaningful use," under which gear becomes eligible for HITECH stimulus money, will be phased-in.

(Were you at the Theta Chi alumni pig banquet at North Dakota State in February? Neither was I.)

In other words CCHIT won't be able to legally prevent vendors from getting subsidies in the near-term, because requirements for 2011 money are pretty basic.

  • Capture data in a coded format. This means medications, drug allergies, vital signs and lab reports.
  • Use eprescribing and check for adverse reactions through a database.

The idea would be to tighten things up gradually, so that by 2013 doctors are using clinical decision-support systems and by 2015 they have a robust EMR system in place for all patients.

Privacy is not defined. Specialists are not required to have more support than generalists. The coding format is not specified. Integration is not addressed, and CCHIT's role is not mentioned. These issues upset some members of the committee as they addressed the media after the meeting.

The real danger, however, is that the CCHIT certified systems all meet the 2011 standards, and can advertise themselves as meeting them. It should also be added that CCHIT favored the phased-in approach in its April testimony to the group.

A "logo" campaign by CCHIT could also be very powerful in the market, with buyers asking open source vendors why they don't have them. A monopoly does not have to be legislated to exist.

CCHIT head Mark Leavitt tried to finesse this point in April, suggesting "experimental" certification for some projects and grants to allow "vulnerable populations" to get non-certified gear.

But that's rhetoric. More action is still needed to guarantee open source, open standards and innovation a seat at the health IT subsidy banquet. The group is now soliciting comment on the recommendations. Hit the link.

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