Senate Health Committee Chair: Meaningful Use Promise Unfulfilled

The chair of the Senate committee overseeing health issues on March 17 railed against the Obama Administration’s handling of the electronic health records meaningful use program.

While about half of physicians and hospitals have adopted at least basic EHR systems over the past six years, Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health, Education, Labor, and Pensions Committee, charged that despite spending $30 billion to date of the HITECH Act’s $35 billion earmarked investment the Medicare and Medicaid EHR Incentive program has not fulfilled its promise.

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“The hope was that the program would improve care, improve coordination, and reduce costs,” said Alexander. “The evidence suggests these goals have not yet been reached.”

In testimony before the committee, Robert Wergin, M.D., president of the American Academy of Family Physicians, told the senators: “Physicians across specialties are deeply frustrated with EHR functionality and the fact that systems do not meet their workflow needs. In addition, these systems can reduce efficiency and have limited interoperability.”

Alexander argued that physicians and hospitals have struggled with meeting the meaningful use requirements so much so that the Centers for Medicare and Medicaid Services has been forced to delay or change requirements three times.

“Half of physicians have not met the requirements of the program and are now facing penalties,” Alexander told his committee “The administration seems to have complicated the process by rushing ahead with penalties for those who don’t adopt EHR systems.”

He added: “Instead of government trying to make everybody do this by taking away Medicare payments, a better route would have been to find ways to enable and encourage their adoption. But instead the administration rushed the process with its penalties—and at the same time made the federal government the arbiter of IT quality.”

In addition, the committee chairman asserted that interoperability between EHR systems continues to be an elusive goal despite the hundreds of millions of dollars that hospitals have spent to implement and continuously upgrade their systems.

“An agreed-upon set of standards, implemented in a consistent way, would undoubtedly facilitate interoperability. But the underlying issue is that we don’t have the incentives in place to make this a reality,” testified Julia Adler-Milstein, assistant professor of health management and policy at the University of Michigan’s School of Public Health. “EHR vendors do not have a business case for seamless, affordable interoperability across vendor platforms, and provider organizations find it an expense that they often can’t justify.”

Peter DeVault, director of interoperability for EHR vendor Epic Systems, said there has been confusion and misinformation about what the company’s software will support.

“Epic does not own or claim rights to our customers’ patient data,” DeVault insisted. “We do not interfere with their ability to access patient data and we do not resell patient data.” He added that Epic gives its customers “access to our source code” and provides “tools that support the free flow of information between different systems and different organizations.”