Personnel Losses Leaves ONC 'Essentially Adrift'
NBER report aside, meaningful use has been under fire for quite some time. Far fewer hospitals and eligible physician providers have attested for stage 2 of meaningful use than stage 1, though ONC continues to view meaningful use through rose-colored glasses. That's largely because the stage 2 criteria are harder to meet, but the government delivered bulk of the monetary incentives in stage 1.
As the program is currently written, Mark Hagland of Healthcare Informatics points out, "Without some kind of remedial backstopping ... massive numbers of hospitals and physicians will face penalties after 2017."
Hagland expresses further concern that ONC remains "essentially adrift" without a full-time leader. Meaningful use faces an "impaired" present and an uncertain future, with the requirements for stage 3 (set to begin in 2017) largely undefined.
What's more, the industry demands guidance on a bevy of additional priorities — security, interoperability, data exchange, the transition to ICD-10, the accountable care organization and other facets of healthcare's changing business model, wearable tech and other forms of mobile health, patient engagement, meeting unaligned federal regulations and trying to catalyze innovation in an industry that, by and large, still relies on paper records and fax machines.
ONC — as well as HHS at large — admittedly finds itself between Scylla and Charybdis. Too much regulation (medical devices) can do just as much harm as too little regulation (interoperability). Moving too quickly (meaningful use) can cause as much frustration as moving too slowly (telehealth). Politics can explain some industry challenges (reform's uncertain future) but not others (public perception of Healthcare.gov).
That said, healthcare wants to change. Healthcare has to change. As healthcare continues its rapid, unprecedented march toward modernity, industry leaders have every right to expect — no, demand — a strong, confident voice in their corner. Right now, ONC can barely muster a whisper when, instead, it should be shouting.
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