Federal Health IT Standards Still Taking On Water


Last May, this blog discussed the proposed watering down of standards for hospitals and other facilities to get federal bounties for so-called “meaningful use” of electronic health records (EHRs) in 2014.

Well, they appear to have done it again. In a final rule that affected both 2014 and 2015, the Office of the National Coordinator of Health Information Technology (ONC) announced that: “Health information technology (IT) developers, providers and consumers will get more flexibility through a final rule issued on Sept. 10, 2014.”

Fierce EMR, a trade journal, summarizes the development:

The new final rule, to be published in the Federal Register Sept. 11, explains that while ONC still believes that many of the reasons for creating the voluntary certification edition were valid, “upon consideration of public comment, further reflection of ONC goals and timelines, and a desire to adhere to the administration’s principles…we have not adopted the Proposed Voluntary Edition.”

Instead, ONC says it will adopt “a small subset” of its original proposals in the Proposed Voluntary Edition “as optional 2014 Edition EHR certification criteria,” which is also referred to as the “2014 Edition Release 2” or “2014 Edition Release 2 EHR certification criteria.” ONC also says it has made revisions to 2014 Edition EHR certification criteria “that provide flexibility, clarity, and enhance health information exchange.”

The ONC keeps lowering standards for a very simple reason: Its very future as a dispenser of Uncle Sugar’s largesse is threatened, so it cannot take the risk of completely alienating the industry it subsidizes and regulates, lest that industry abandon it.

As I recently discussed, $26 billion of taxpayers’ money has been spent in a few short years to induce healthcare facilities to install EHRs that have not proved very useful. There is only $4 billion left to go, and then ONC has to go to Congress to get funded again — perhaps, some advocate, by a trust fund with ten years worth of money in it!

ONC is dependent on the EHR industry to lobby for this funding. The EHR industry is dependent on ONC for its revenue. So, it is not surprising that the industry succeeds in arguing that the original standards are too hard to achieve. The relationship between these two is a co-dependency unhealthy for American patients and taxpayers.


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