Newton Correct: Reaction to Final Meaningful Use Rule Equal, Opposite

This morning, the Office of the National Coordinator for Health Information Technology (ONC) made its definitive ruling on what constitutes “meaningful use” with regard to qualification for incentive payments under the HITECH Act, “enacted as part of the American Recovery and Reinvestment Act of 2009…to promote the adoption and meaningful use of health information technology.”

Click here for a recap of today’s live announcement.

The full document can be found at Healthcare, Technology & Government 2.0 and HIS Talk.

ONC received more than 2,000 comments about the rule, which was proposed in December of 2009, so it would make sense that reaction within the healthcare community was heavy and (predictably) all over the board.

The American Hospital Association was nonplussed, forcing out a compliment—“hospitals will have some additional flexibility in choosing which measures to use to qualify as ‘meaningful users’”—before complaining “that the requirements may still be out of reach for many of America's hospitals and more analysis is needed to determine the overall impact on hospitals. ‘Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption by our nation's hospitals and physicians,’ said AHA President and CEO Rich Umbdenstock.”

Insurers—UnitedHealth Group, AHIP—reacted positively, but not nearly as enthusiastically as the AARP or (go figure) vendors like AllScripts and Medsphere.

AARP Executive Vice President John Rother commended the final ruling because it “gives doctors and hospitals financial incentives to use technology to improve quality and by giving patients easy access to their personal health information, the final ‘meaningful use’ regulations will significantly advance the necessary transformation to a system in which everyone has a certified electronic medical record.”

AllScripts couldn’t resist a sales pitch: “This is a milestone for our industry and one that sends a clear message to physicians. The tipping point is here and the time to act is now.”

One of the more substantive reactions came from the blog Health Care Renewal, which posits that everyone is just throwing themselves a party over the ruling with no good reason. In fact, they say, this occasion should be viewed quite skeptically:

“By what category of diligence were the rules for ‘meaningful use’ finalized on the same date that a NIST conference is being held on health IT ‘usability’ (Usability in Health IT: Technical Strategy, Research, and Implementation), implying there's a problem with usability of these experimental devices physicians are supposed to ‘meaningfully use?’

Don't take my word on the issue of usability problems."

The post then highlights numerous reports which have found, among other things, that current health information technology may not only be unreliable, but unsafe, and that current efforts to foster HIT adoption “may even set back the cause.”

“Are we are entering an era of cybernetic medical assault on our patients (and perhaps criminal negligence and manslaughter, a term I do not use lightly) through irrational exuberance in computing -- and through exuberance about the profits to be made by the HIT industry?

Unless we slow down in our exuberance and recklessness on HIT diffusion, my fear is that we very well might be."

How do you feel about the ruling? David Blumenthal, MD, the National Coordinator for Health IT, said that the old "rule was too inflexible" during the conference. Does he have it right? Is this a wonderful occasion, as the AARP seems to feel? Something to be taken with a grain of salt, a la the AHA position? Or something else entirely, something that should be completely rethought, as our colleagues at Health Care Renewal suggest?

The discussion begins here...