More often than not, opportunity is a better incentive than regulation

One time-honored question in policy circles goes like this: Should government prescribe specific solutions, or just point to the goal and let industry stakeholders figure out how to get there?

While not a perfect example, HHS seems to have answered a version of this question by scaling back the EHR requirement it had proposed as part of its rules for Accountable Care Organizations (ACOs).

What strikes us as most interesting about this move is the reaction of some providers to it. The announcement coincided with the annual symposium of the Connected Health Center (CCH), and as this report tells it, some reacted to the news “with a shrug.”

According to Joseph Kvedar, MD, CCH’s founder and director, "I don't necessarily think that's a bad idea because I can't imagine anyone [creating an accountable care organization] without an EHR.”

That thought was echoed by others in attendance, and it leads us to wonder if, over time, the whole Meaningful Use discussion/debate is going to slip ever further into the background. Why? Well, because health IT is bound to keep developing, and as it does new healthcare delivery structures will become possible, and participation in those structures is going to require providers to be HIT savvy.

For another angle on this question, note the comments by Dr. John Halamka in this MU-focused interview. When asked about the perceived lack of specificity in some parts of MU Stage 2, as opposed to MU Stage 1, Halamka “points out a lack of specificity in some criteria may actually be a good thing, giving healthcare providers more opportunities to innovate and implement technologies that work best for their organizations.”

The point is, regulation at times serves an obvious purpose, but in order to bring about system-wide change nothing will work better than a community that is engaged and sees the value in moving forward. Put another way, presenting someone with an opportunity will usually be a better incentive than presenting them with a whole new bunch of rules.