Halamka offers strategy to move beyond MU
Meaningful Use (MU) has served its purpose and it's time for a new plan, according to John Halamka, MD, CIO, of Beth Israel Deaconess Medical Center, writing on his blog, Life as a Healthcare CIO.
Halamka has previously called for the end of the incentive program, saying it’s too prescriptive and the market can now take over.
In his latest post, Halamka also says he doesn’t believe that vendors or other organizations are purposely blocking information. “The barriers are lack of enabling infrastructure, data governance, uniform policies, appropriately constrained standards and economic incentives. Focusing on information blocking is a distraction.”
Regulation is not the solution, he wrote. The layers of requirements in the various laws “are so complex and confusing that even government experts struggle to understand the implementation details.
“I do not believe that adding numerous structured data elements and new quality measures to existing software creates disruptive innovation. We need a business imperative for change and innovation based on the needs of customers.”
Halamka also believes that health IT developers have committed to piloting and developing Application Program Interfaces (APIs) and “creating regulation before there is any industry experience as to what works makes little sense. Government can help with issues such as data governance principles, rationalizing privacy policy, and coordinating federal agencies but should not specify workflow or business process.”
Moving forward, Halamka said we should do the following five things:
- Replace MU with Alternative Payment Models and Merit-based Incentive Payments as part of the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). "If alternative payment models offer compelling reimbursement for health and wellness, then clinicians and hospitals will adopt products and change behavior to achieve that goal," wrote Halamka.
- Replace certification with enabling infrastructure. Halamka suggested a national provider directory, a master patient index/relationship locator service, a consent service, a certificate management service and test beds for developers to exercise these services.
- Consider evolving the role of ONC to become a focused policy shop (supported by advisory committees) with a narrowed scope such as identifying ways to reduce errors, improve safety, enhance quality, accelerate interoperability and meet the needs of diverse populations.
- Stop considering health IT developers and providers as the enemy. "Some believe health IT developers are responsible for creating information silos or resisting interoperability. Some believe clinicians are lazy or greedy, requiring government mandates to become patient-centric. I’m sure there are exceptions, but in general, both are myths."
- Focus efforts on a few things that really matter. The Federal Interoperability Roadmap has 117 goals, he wrote, and the certification program "has so many objectives that it takes a few hours just to read them all."
“More Meaningful Use and Certification criteria are not the answer," Halamka stressed. "Paying for outcomes that encourage government, payers, providers, patients and health IT developers to work together, instead of being adversaries, is the path forward."
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.