Consumer Groups, EHR Vendors Talk Back to GOP Senators

Fourteen consumer organizations in a joint letter advise six Republican members of the U.S. Senate to not seek to pause or delay the electronic health records meaningful use program.

“Meaningful use is just beginning to pay off--and it is only in its first, and by design, most basic stage,” the organizations say. They argue that transforming the nation’s health information backbone on a dime is not possible, and that Congress was wise in creating a strategic and quickly phased approach in 2009 that should continue to be followed.

The consumer groups, members of the Consumer Partnership for eHealth or the Campaign for Better Care, acknowledge the senators’ concerns with meaningful use but say stopping for re-examination is not the answer.

Routine assessment and improvements of the program are necessary, but Stages 2 and 3 should remain on schedule or be accelerated, according to the consumer organizations. The groups also argue that dramatic progress had been made in four years on interoperability and that delaying meaningful use would postpone cost savings while impeding improve access and care quality.
“Many of our best, evidence-based ideas to change the way we pay for and deliver care hinge on the availability and seamless exchange of health information to introduce efficiencies and cost savings, and to provide the kind of care that improves patients’ health. They require measuring and rewarding value and quality over volume. But we simply cannot measure health outcomes or efficiency without EHRs and the structured evidence they make available.” The consumer letter is available here.

In addition, a coalition of electronic health records vendors takes issue with the GOP senators’ contention that the meaningful use program lacks a clear path toward systems interoperability.

“Although nationwide exchange of health information has not yet been fully achieved, Stages 1 and 2 of the EHR Incentive Program and ongoing industry efforts have made significant advances toward broad interoperability,” according to a letter to the senators from the HIMSS Electronic Health Record Association. “In fact, interoperability among health I.T. systems exists widely today within healthcare organizations. And with growing numbers of health information exchanges and the availability of newer models of exchange (e.g., the Direct protocol and Integrating the Healthcare Enterprise document management profiles), interoperability is rapidly increasing among provider organizations.”

The Republican senators recently called for a pause in the meaningful use program to re-examine its strategies.  Apart from interoperability concerns, they also worry that EHRs are not saving money and may be contributing to fraud, lack adequate security, and question if EHRs are sustainable after grant funds and incentive payments run out.

The emergence of accountable care organizations and other new care delivery and payment models, along with enhanced requirements in Stage 2, are increasing demand for interoperable data exchange across providers, the vendors note in their letter. “The business case for the needed investment is becoming clearer at the very time that EHR capabilities are being enhanced to support such exchange.”

The vendors dispute that use of EHRs have led to inappropriate or inaccurate coding, and contend there is evidence that EHRs can save money through use of clinical decision support and other capabilities. The complete comment letter is available here.