Lies, Damn Lies and Politics
Six GOP Senators call for overview of Meaningful Use EHR incentive program was the tweet. It referenced this link. Which then referred to this report by Senators Thune, Alexander, Roberts, Burr, Coburn and Enzi.
To be clear, I'm a card carrying Liberal, and the six Republican Senators whose names are on this report voted against ARRA and HITECH. It's already pretty clear that we'd disagree on some things. Yet, reading through the report, I find many statements I could agree with. There were many others which I was quite cautious about, given that the Senators compared apples to oranges.
What annoyed me most were the at least two very clear misstatements of fact. Given what the senators (or their ghostwriters) should know, I can call those nothing other than an outright lie. If there's something I hate worse than BS in headlines, it is outright lies in reports like this one.
Lie #1: "None of the required core or menu objectives in Stage 2 requires communication with other health care providers." (page 11, paragraph 2).
In the meaningful incentive regulation:
495.6 (j)(14)(i) Objective. The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral.
495.6 (k)(1)(i) Objective. Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through Certified EHR Technology.
495.6 (l)(11)(i) Objective. The eligible hospital or CAH that transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral.
495.6 (m)(2)(i) Objective. Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through Certified EHR Technology.
495.6 (m)(6)(i) Objective. Provide structured electronic lab results to ambulatory providers.
They missed not just one, but five separate interoperability requirements that require communication with other healthcare providers (and I haven't included a single of the "communicate with public health" requirements which also have interoperability requirements).
Lie #2: Even worse, on top of this, providers will be penalized for not all reaching a common milestone (page 13, paragraph 1)
CMS has only stated that there will be penalties for providers not achieving meaningful use after 2015. It has not required providers to achieve the same stage of meaningful use in the incentives regulation.
Not on top of the facts #1: One of the key program vulnerabilities of the current HITECH program is that providers simply self report to CMS that they have met meaningful use criteria in order to receive federal funds. This is a startling lack of program integrity.