Electronic Health Records

Adoption & Implementation News

Mostashari defends meaningful use before Finance Committee

By Kyle Murphy, PhD

Considering the polarization meaningful use has engendered, the environment was much more collegial than combative during Wednesday’s hearing before United States Senate Committee on Finance, “Health Information Technology: A Building Block to Quality Health Care.” The hearing gave proponents and opponents of the motion to pause the EHR Incentive Programs the opportunity to argue their sides.

Although two witnesses gave testimony before the Finance Committee, it was rather clear that the presence of the National Coordinator for Health Information Technology Farzad Mostashari, MD, ScM, was the most integral — no offense to Patrick Conway, MD, MSc, of the Centers for Medicare & Medicaid Services, who also provided testimony and answers to questions posed by committee members.

In his written testimony, Mostashari detailed the progress made by meaningful use and the adoption of EHR systems and participation in health information exchange. However, it was in response to questions from Chairman Max Baucus (D-MT) and Ranking Member Orrin Hatch (R-UT) that the matter of delaying the EHR Incentive Programs came to a head.

Perhaps with the debacle surrounding the joint EHR efforts of the Departments of Veterans Affairs and Defense in mind, Sen. Baucus immediately cut to the chase: “How are we doing here? Are we on track? Any delays?”

Mostashari was adamant in his response that the earliest phase of the EHR Incentive Programs was having a positive effect on transforming the healthcare industry:

We are finishing Stage 1 and we’ve had, I think, good results in terms of participation and achievement of the standards for Stage 1 and we’re working in 2013 on implementation of Stage 2, which is going to be a big step forward particularly around patient engagement and interoperability. We’re going to continually monitor where we are and how we’re doing, how things are going, and react and adapt as needed.

Although satisfied with Mostashari’s response, Sen. Baucus warned that he didn’t want the committee’s support of the program to be exploited.

“This committee wants to help, so let us know,” the chairman explained. “Just don’t blindside us with a telephone call one day saying, “Uh oh. We’re not doing this.” Rather, let us know if there are areas we can help in one way because clearly I don’t know a senator who doesn’t believe health IT is a critical component.”

The most pivotal part of the hearing came when the floor was handed over to Sen. Hatch, who after playfully complimenting Farzad’s bowtie (maybe he’s the one behind the mysterious twitter account) — “I’m kind of envious to be honest with you” — wasted no time in asking the day’s most important and pressing question:

Do you believe that a pause in meaningful use payments to hospitals and eligible providers would allow us to evaluate progress and readjust if necessary to get the return on investment that we’ve searched for with the Electronic Health Record Incentive Program? And should a pause also coincide with a delay in penalties for the non-adopters?

Mostashari’s response was both clear and emphatic:

No, Sir. I believe that a pause in the program would stall the progress that has been hard fought. The movement that we’ve accomplished through Stage 1, we need to give Stage 2 a chance to move ahead and meet the urgency of the moment in providing support for coordinated care for the transformation in healthcare, and I believe that a pause would take momentum away from progress.

Proponents of #EHRbacklash are likely disappointed that meaningful use lives to fight another day, but this is clearly not the end of the debate over meaningful use now that federal government is keeping a close eye on the EHR Incentive Programs.

Written testimony and streaming video from yesterday’s hearing are available here.

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