In April six senators, led by Senator Thune (R-SD), sent a letter to Secretary Sebelius expressing concern that the money being spent on the EHR incentive program was not was not achieving its intended objectives for the country. They detailed these concerns in a white paper called “REBOOT: Re-examining the strategies needed to successfully adopt IT.” Among their concerns is that the Meaningful Use program:
- Lacks a clear path toward interoperability
- Has made payments to providers without evidence of meaningful use
- Is leading to increased ordering of unnecessary tests and increased billing due to more widespread use of EHRs
- Provides inadequate safeguards against fraud and abuse
- Does not require providers to demonstrate their technology is secure
- Does not assure sustainability with penalties hitting providers, especially small providers
- Created a patchwork of overlapping reporting requirements
The white paper was part of a broader Senate effort to solicit feedback from the Obama administration and the provider community about the EHR incentive program. Some of the information in the white paper is accurate; some is misguided or just plain inaccurate.
During the week of July 1, HIMSS Government Relations and the Institute for eHealth Policy were asked by lead staff of the Senate “Reboot Group” to convene a series of closed-door, bipartisan Senate staff briefings to assist them in preparing for what were likely to be at least three upcoming Senate Finance Committee hearings on the status of HITECH, beginning on July 17 with ONC and CMS as witnesses.
The first briefing was scheduled for July 10. HIMSS arranged for me, as HIMSS Chair-elect and head of the North Dakota-Minnesota Regional Extension Center (REACH), to brief Senate staff, along with Elliot Sloane, PhD, an expert on data standards and co-chair of the IHE (Integrating the Healthcare Enterprise) International Standards organization, and Janet Marchibroda, Director of Health Innovation at the Bipartisan Policy Center.
This briefing was attended by 36 Republican and Democratic Senatorial staffers. The three of us updated them on what the incentive program has already been able to accomplish, and the data that show the program has clearly driven increased adoption of electronic health records. We also pointed out that the interoperability standards that are required for Stage 2 will include the ability and requirement to exchange patient information across silos of care. Finally we described how reporting requirements are being harmonized, allowing providers to report once and satisfy several programs.