Halamka shares advice for ONC's DeSalvo

John Halamka, MD, health IT thought leader and CIO of Beth Israel Deaconess Medical Center in Boston, has some advice for the new national coordinator of health IT.

In a post on his blog, Halamka laid out five recommendations for Karen DeSalvo, MD, MPH, MSc. Rethink the certification program is first and he says "some of the 2014 certification test procedures have negatively impacted the healthcare IT industry by being overly prescriptive and by requiring functionality/workflows that are unlikely to be used in the real world."  He mentions the concept of certification only in which  "no actual clinical use or attestation is required but software must be engineered to incorporate standards/processes which are not yet mature." He provides the transmit portion of the view/download/transmit requirement as an example. It's simply too soon to make this an attestation requirement.

Halamka also recommends that DeSalvo evaluate the collective timelines of Meaningful Use, ICD10-CM, ACA and the HIPAA Omnibus Rule. "Thousands of pages of regulations are hitting the industry at the same time and it's clear that like healthcare.gov, haste will make waste."

Halamka says Meaningful Use Stage 1 was a "phenomenal success," so DeSalvo can "declare victory" for the program. "Stage 1 was seen as a tide floating all boats."   Now, he says it's time to eliminate penalties for non-compliance and "return EHR innovation to customers and vendors."

The Office of the National Coordinator of Health IT (ONC0 should fund pilots and research, Halamka says. "We are on the cusp of a sea change in interoperability, population management and clinical decision support." Pilots are needed to enable incremental progress and "create a tipping point which mitigates risk and enables progress."

Finally, Halamka says ONC should continue its convening function for standards, privacy/security and hearings to capture lessons learned about adoption and implementation.

"Karen is the right person for the job at this time in history, just as her predecessors were the right people for their eras," he says. "She can regain the trust of Congress, make midcourse corrections to the Meaningful Use program and balance the burden/benefit on stakeholders. If she can rebuild a city's health system after Katrina, she can polish those elements of the ONC strategy that experience in the marketplace has deemed to be necessary."

Read the entire post.