Provider groups raise a clamor over 'meaningful use'

Health providers and IT policymakers returned from the holiday weekend on Monday having had just enough time to sort through the administration's "meaningful use" proposal, its 700-page incentive plan designed to spur hospitals and physicians to pursue digital make-overs of their practices. Their first impression: That the administration's hugely ambitious, carefully crafted, $20 billion incentive plan may provide too much stick for the carrot.

Observers noted the Office of the National Coordinator and the Centers for Medicare and Medicaid Services had to set up a delicate balance in designing the incentives ­ making them challenging enough to have a lasting impact on health outcomes but not so burdensome as to stall adoption. "ONC and CMS are between a rock and a hard place," said Dr. John Loonsk, the former director of interoperability for ONC and now chief medical officer for CGI Federal Inc., an IT services firm. The challenge they faced, he said, is to "thread the needle with enough requirements and specifications to create a viable, secure electronic infrastructure without, in doing so, making the adoption of electronic medical records less attractive to the providers they want to adopt them." Meaningful use planners were trying to create a balance between spurring adoption and achieving an infrastructure with enough "technical rigor" to mobilize data in ways needed to improve health outcomes, Loonsk argued. "It would have been appealing if (the HITECH Act which funded the incentive program) focused more on these data needs," said Loonsk, "but ONC and CMS are now trying to find the right balance to make HITECH work."