Matthew Holt

Beating up on ONC, mostly unjustified

Earlier this week there was a curious little hearing at Pete Stark’s committee. Much of the Q & A—mind you post the announcement of the final meaningful use rules—was (apparently, as I can’t find the transcript) a beating up on the poor folks at ONC for reducing the barriers towards meaningful use. Here’s Jonathan Hare of upstart privacy/identity/network vendor Resilient explaining that things are not tough enough.

While Jonathan is having a bit of fun here (and, oh by the way, he does actually have a solution for the inadequacies of current HIEs which we’ll be showing you more about in the world of Health 2.0), some of this and the other stuff the ONC folks had to deal with was a little tough. They got a fair amount of abuse from the committee.

Some of which I agree with in spirit:

Rep. Wally Herger (R-Calif.) claimed that “by watering down the final regulations we have missed an opportunity” to improve patient care and reduce waste of taxpayer funds.

But if you listen to the testimony from the CIO of a University Hospital in Ohio, the man from NextGen (EMR vendor), and a family practice doc from New York—not to mention all the vendors interviewed by Inga at HISTalkPractice—you’ll realize that there were reasons for the slowdown. Not the least of which was that this relatively advanced bunch all were saying that even with the reduced demands of the new rules, it was going to be hard for them, let alone the majority of doctors and hospitals who haven’t started yet, to make it to meaningful use.

And remember that back in March 2010 249 members of Congress wrote to CMS urging a slowdown in the pace for HITECH meaningful use rule adoption. That group was led by a Conservative Republican called Tom Price. So we have Republicans saying speed up and slow down; and Democrats too no doubt mouthing the same thing.

In the end the folks at ONC & CMS have to thread the needle. First, they do need to get the money spent (This is a stimulus measure after all, and you may not have noticed but the economy could use it!). Second, they need to get most providers on board, and at the moment that’s not the case. Third, they need to get value for the taxpayer. I think that their approach is reasonable.

So lets stop arguing about the measure and lets get some technologies deployed that will be easy to adopt (SaaS) and crack the interoperability conundrum. And I think that Jonathan Hare and many others will be able to use the next two years to show how that can be done.

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5 replies »

  1. Is there a video of the entire hearing at Way and Means, including the q and a? Please provide the link.

  2. I respectfully disagree with Jonathan Hare. He may have “the solution” to securing data, but there is no data to secure. It’s mostly on paper right now. You cannot secure something that does not exist.
    He may be able to deploy his solution in one year (very doubtful), but getting electronic data will take much longer than that. And from day one Meaningful Use did not require widespread data exchange – only testing capability to do so. Nothing has been relaxed in that respect in the final rule.
    We already have several carts in front of our horses. Placing a few more carts in front of the ones already there will accomplish nothing but guaranteed failure.
    Mr. Hare is forgetting one thing: physicians don’t have to go along with this hare brained (no pun intended) idea of having a national HIE by 2011. I’ll be surprised if even half go with the more modest Meaningful Use.
    Pure technology folks tend to have no understanding of physicians and no patience for their doubts. I do appreciate the value of having the Government pay for the use of what you sell. However, it will take time and patience and some really big players like IBM to clean up the mess, and if Mr. Hare has such great technology, it will be acquired.
    ONC is doing the right thing. Slow the train down so everybody, including the heavy footed, can get on board. Only then you may accelerate….

  3. Actually, I think he’s right about a lot of what he is saying, but I bet he doesn’t have enough of his fellow technology competitor’s agreeing on his model and vision. Why don’t guys like Jonathan build a coalition (or two or three) of industry leaders and heavy hitters to endorse an exchange model/standard platform, resulting in commitments for their products to support it? Manufacturers do this — think about the coalitions that formed to support Blu-Rav vs. HD-DVD (and one emerged). So for instance, invite Microsoft and Google into the same room, get them to commit to work together on a PHR standard development platform and then agree to support it with their products. They can still have very different products, but they interoperate on the same information exchange standard. Then present that to the Government with a plea to support it nationwide.
    Rick’s Place

  4. The stimulus is being wasted on crap devices that are unsafe, unusable, and in many cases, unnecessary. This is a criminal fraud on the taxpayers. The HIT vendors have deceived Congress and the White House. Have there been kickbacks? Just wondering.

  5. An executive with a large amount of money at stake, wants federal policy to reflect what would be best for his company. Like the French Colonel in Casablanca who finds gambling going on in Rick’s place – I am shocked!

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