Meaningless Talk Of Repealing Meaningful Use Programs

Members of Congress looking to gut the $27 billion in funding that's set for the Health Information Technology for Economic and Clinical Health (HITECH) Act's meaningful-use incentive program aren't accomplishing much besides creating more confusion, uncertainty, and excuses for the nation's already stressed out healthcare providers.

The threats to pull back funding for HITECH programs, as House Republicans look to cut discretionary spending, are equivalent to bait and switch to thousands of Luddite, laggard, or just cash-strapped doctor offices and hospitals that are finally, seriously plotting their moves into 21st century record-keeping technologies and processes.

Making matters worse, the chance of the meaningful-use funding actually getting axed is virtually nil, considering the Senate likely won't pass such a bill, and President Obama wouldn't sign it anyway.

So, the repeal talk just ends up being a big, unnecessary distraction, especially to on-the-fence healthcare providers who are leaning toward participating in the reward program, but now are taking a time-out to figure out the politics, when they should be focused on meeting compliance requirements and deadlines.

"There are still those providers that are looking for any excuse to wait," said Patti Dodgen, CEO of Hielix, a provider of health information exchange (HIE) services. "There's a lot of frustration out there right now," she said, in an interview with InformationWeek.

But even if there is scant chance of defunding HITECH now, looking ahead, the threats plant the possibility that the pool of incentive money being set aside could get slashed at some point before the meaningful-use programs are set to end in 2014, said Chuck Christian, CIO at Good Samaritan Hospital, a 232-bed community hospital in Vincennes, Ind.

"We might see a reduction in how much money is spent," Christian said. But even if the allocated funding stays intact, "the program was never designed to make sure everyone gets money," he said.

"If you're late to the game, you'll get a reduced amount. There's a finite bucket of money, when it's gone it's gone," Christian said in an interview with InformationWeek.

HITECH funding or not, Christian's organization had been on its own mission of implementing and meaningfully using health IT for several years before the stimulus program was signed into law by President Obama in early 2009.

The government's meaningful-use programs have only slightly changed the focus of what Good Samaritan is working on. For instance, rolling out computerized physician order entry (CPOE) "was on the list for a long time" at Good Samaritan, said Christian. But for 2011, CPOE has moved up on the to-do list, in part because Good Samaritan has completed other tech implementations that are also part and parcel of patient-safety initiatives, including rolling out a new pharmacy system. CPOE not only fits Good Samaritan's larger safety mission, but CPOE is also required for compliance with Stage 1 of the meaningful use programs.

"We're not doing this because we think we'll get a windfall, we're doing it because it's the right thing to do," Christian said. In any case, "if you look at how much money is being spent by [organizations on health IT], no one thinks they'll get back close to what they're spending," he said.

It's worth noting that the widespread adoption of health IT to help reduce costs, waste, and improve patient care has (until now anyway) been painted as a bipartisan-supported goal for the United States. Over the last several years, there have been a number of bipartisan efforts pushing health IT related legislation. And five years prior to HITECH's 2009 passage, Republican President George W. Bush set out the goal for "most Americans" to have electronic health records by 2014.

The biggest differences between Bush's stated goal in 2004 and Obama's plans for health IT are funding and mandates.

It's only three years till 2014, but Bush's vision for most Americans having a digitized health record could be closer to reality than anyone honestly predicted while Bush was still in office. But let's face it, that's largely because the HITECH incentive programs are pushing laggards that probably wouldn't have otherwise made the digitization jump on their own.