Monday, November 5, 2012
The Election and Healthcare IT
Tomorrow the Presidential election process comes to an end and the advertising will finally stop. We'll all be relieved. I especially look forward to a quiet dinner at home without robotic election-related calls.
What about healthcare IT? Will differences in the Obama and Romney platforms impact the momentum of Meaningful Use?
Here's what I believe.
The Obama Healthcare IT platform builds on what we've created over the past few years. It will continue to leverage the federal advisory committees (Policy and Standards) to engage a wide array of stakeholders. It will persist the progression to Meaningful Use Stage 3 and possibly future stages. It will embrace certification now the temporary certification process has been replaced with a permanent one. It will support the initiatives of the Standards and Interoperability framework (S&I), although the end of stimulus funds from ARRA means that ONC will move some of the S&I initiatives to private/public partnerships. It will support the current leadership at ONC - Farzad and his delegates such as Steve Posnack, Doug Fridsma, and Judy Murphy.
The Romney Healthcare IT platform notes that information technology has broad bipartisan support. No one argues that a foundation of healthcare IT implemented properly is essential for accountable care organizations. Quality, safety, and efficiency all benefit from the process enhancement afforded by healthcare IT. Michael Leavitt, former Secretary of HHS and chair of the American Health Information Community (AHIC) will lead the Romney transition team and Leavitt has years of experience with healthcare IT issues from the early days of ONC. As Governor of Massachusetts, Romney supported the early EHR rollout efforts of the Massachusetts eHealth Collaborative.
However, there have been aspects of the Romney Healthcare IT platform which are concerning.
In my conversations with reporters, there has been a consensus that the Romney campaign will terminate stimulus related programs such as Meaningful Use. I'm concerned that eliminating Stage 2 and 3 stimulus dollars would slow the pace of adoption we've achieved over the past few years.
Further, the Romney campaign has noted that interoperability standards are lacking and if vendors are given a mandate, standards will be widely adopted.
I'm concerned that Romney's advisors do not realize how successful the federal advisory committee process has been. The Healthcare IT Standards Panel (HITSP) in the Bush administration was a wonderful group of people trying very hard to make a difference. When Obama was first elected I suggested that continuing HITSP would be better than forming a new federal advisory committee (Healthcare IT Standards Committee - HITSC).
Over the past four years, I've realized that HITSC has engaged more stakeholders and recommended simpler, easy to implement standards because it was not dominated by vendors which introduce their own biases. Giving standards-making to a consortium of vendors would be a step backwards.
I always try to ignore election year politics and work above the fray. Regardless of who is elected, I will work with them and continue my passion for standards and interoperability.
If Romney is elected let's hope he is a funder of healthcare IT and not just a cheerleader. Let's also hope that he examines the lessons learned over the past 8 years and realizes that we're on the right track for interoperability. Eliminating meaningful use and turning standards-making over to the vendors would not accelerate our progress.
Posted by John Halamka at 3:00 AM