By Diana Manos
The electronic health records (EHR) incentive program began with the best of intentions: to improve healthcare. And many would argue that it has made inroads. If nothing else, it has brought America into the 21st Century for medical record-keeping, moving the majority of providers from paper to digital records
The undertaking has been massive. Since the program began in 2010, more than half a million providers have transitioned to EHRs, to the price-tag of nearly $32 billion in total incentives paid out.
Mandated under the Health Information Technology for Economic and Clinical Health (HITECH) Act, the incentive program was intended to usher in the age of higher quality, more efficient, safer healthcare—and more importantly, to lay the groundwork for improving health at the population level. The hopes of healthcare providers, policymakers and other stakeholders has been resting on the meaningful use program to catapult U.S. healthcare to a higher level.
However, the bureaucracy behind the program and the increasingly difficult burden on providers brought a backlash that has been steadily increasing from all corners, calling for the federal government to reconsider the ultimate fate of the program.
Now, with just two years left to go, it looks like the Centers for Medicare & Medicaid Services (CMS) is pulling the plug on the program.
At the J.P. Morgan Healthcare Conference, held Jan. 11 in San Francisco, CMS Acting Administrator Andy Slavitt shocked the healthcare world when he said, “The meaningful use program as it has existed will now be effectively over and replaced with something better.”
But what is that something better? And how will it all play out? That is as precarious of a question as the EHR incentive program’s current state, but some clues are out there as to what the future might hold. Slavitt said whatever the new program turns out to be, it will:
- Move away from rewarding providers for using technology alone and focus more on rewarding them for patient outcomes;
- Allow more flexibility so that technology companies can build products to suit individual providers’ needs, rather than forcing providers to use federal universally prescribed technology for all providers;
- Encourage the use of application program interfaces (APIs), to allow apps, analytic tools, and connected technologies to get data in and out of EHRs securely;
- Get “deadly serious” about interoperability.
Many people would have sworn America has been “deadly serious” about EHR interoperability, all along. But that has been so much easier said than done, especially with the meaningful use program allowing the federal government’s heavily bureaucratic and prescriptive hands to be involved in every aspect of the progress.
Complaints from every quarter have been coming to a head, and it has been abundantly clear that Meaningful Use Stage 3 was going to be nearly impossible for providers to achieve. The EHR incentive program has morphed from its initial steady achievements in adoption, to choking off use altogether.
“We have to get the hearts and minds of physicians back,” Slavitt said. “I think we’ve lost them.”
Recent comments by the American Academy of Family Physicians (AAFP) proves Slavitt’s observations true. “Until the meaningful use program is improved and the EHR issues are resolved, it is difficult to foresee a large percentage of physicians—particularly physicians in small and independent practices—being successful in [future federal] programs.,” AAFP officials wrote to CMS. “EHRs should be a tool for success in a physician’s practice, not an obstacle to overcome.”
Here’s hoping that CMS can find a better way to motivate healthcare providers to use EHRs. Maybe Slavitt’s new list of guidelines will be the key.
Diana Manos is a healthcare policy journalist with more than two decades of experience in the trenches covering federal government agencies and Congress on healthcare and health IT issues. She can be reached at dnewsprovider@gmail.com.
