At last, we have received from Mt. Olympus those much awaited writings….the definition of “meaningful use”!
I understand how we got here. I could put myself in the shoes of government decision-makers at every step of the way and see myself doing the same thing. “Step in and help … EMR adoption is too slow and costs are rising too high … the free market isn’t working, so step in.” I get that.
“Make the definitions hard and truly meaningful so that after we are thrown out of office, the social benefit of this program of ours will outlast the pure stimulus effect and create real social change in the health care market.” I get that too.
“Let hospital-owned practices into the mix. Even though we know they have the money, we want their leadership. Also, lots of docs are affiliated with hospitals.” This one was tough for me even though I have a lot of hospital clients that own practices and are growing that business.
“Delay a little to see if we can get more people to our higher standard.” Okay.
“Delay a little more and signal that maybe the standards won’t be so high … otherwise maybe no one will be a meaningful user.” Okay. Okay.
Now we have the goods. We’ve increased the cost of health care in the following ways:
- We spent billions on attaining meaningless meaningful use.
- We cause vertical integration between hospitals and doctors, giving hospitals more pricing power and more influence over doctors’ referral patterns.
- We got thousands of doctors onto software-based, isolated EMR packages that are systematically not connected to one another and left doctors with no meaningful incentive to work on the interconnection problem themselves.
Bitch, bitch, bitch – why am I complaining? It’s not like the PRIVATE sector did such a terrific job all these years connecting health care! If it had, the government wouldn’t be in here like this. So what now? The private sector had better step up! The fact that meaningful use might be meaningless may actually be a blessing of sorts. There is still room for the private sector to step in and starting MEANINGFULLY exchanging health care information. This administration may be activist, but they are NOT stupid. IF the private sector starts moving health care information around in a way that is safe and starts sowing the seeds of differential payment for differential quality, I am SURE that the government will let it happen.
Or is it? You tell me—what do you think?
Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.