The health advisory committee under David Blumenthal took out deadlines for installing health IT under the "meaningful use" guidelines approved yesterday.
It then named a committee on certification balanced between proponents and opponents of giving the job to the industry-created CCHIT organization.
Meaningful use will define which health IT projects are eligible for stimulus money under the HITECH Act, while the certification organization will guide the actual process for handing out the money.
Instead of imposing deadlines on its recommendations, the group created an "adoption year" mechanism. Once hospitals meet 2011 guidelines they can apply for cash to cover that investment, the same for 2013 and 2015 guidelines.
And the initial guidelines, covering 2011, are pretty modest. Only 10% of orders must be entered electronically to meet the guidelines, for instance. Only one clinical decision must be implemented through software under the guidelines.
This could mean a lot of hospitals and medical practices will be getting checks for work they have already done, using systems that may not meet later criteria.
Over at Better Healthcare Alexander Saip notes that support for heterogenous systems really depends on build-out of the National Health Information Network, calling the lack of coordination a "disconnect." It's one Blumenthal's office needs to take responsibility for.
The more important action may have been appointment of a "certification workgroup" within the advisory committee that will finalize guidelines on how folks will be paid by December.
That group will be headed by an add-on vendor, Paul Egerman of Nuance's eScription unit. and Marc Probst of Intermountain Healthcare, which committed to using Windows-based Centricity software from GE in 2005.
Other members include Rick Chapman of Kindred Healthcare and Charles Kennedy of Wellpoint, the insurer. They are joined by patient advocates Adam Clark of the Lance Armstrong Foundation and Scott White of the SEIU, LaTanya Sweeney of Carnegie-Mellon's data privacy lab, Steve Downs of the Robert Wood Johnson Foundation, California CIO Teri Takai, and gynocologist Joseph Heyman of the AMA.
At first glance, that appears to be a pretty well-balanced group, meaning CCHIT will get a hearing to become the certification authority but they may have to give up much of the power they planned on having to win the nod.
Experts from both sides will be weighing-in on all this next week, and ZDNet Healthcare will report on their reactions.