GALE: I think, as a general rule, KLAS supports a fairly high bar, an aggressive bar, because if we’re all, as taxpayers and as individuals, paying this money to move the bar forward, for heaven’s sakes let’s move the bar forward. I think there should be a stair step approach which might require that in the first three years you get to 50 percent CPOE and then closer to 100 percent over 5 years, so you have a chance to ramp up. So, I think there are some real things that add benefit right off the bat that you should get paid extra money for. Regarding people that can’t get there, I don’t know if they should be punished, but there should be a benefit to the people who can get there.
The challenge, as I saw in the meaningful use definition, is that they weren’t trying to focus on the biggest wins. They weren’t focusing at all, they were going after everything: “We want personal health records, we want you to send alerts to people when they need to come in.” Many of those are impossible in the first year. I mean, we’d like to see a little more focus on the things that will make the biggest difference and actually advance the care of patients, and then, maybe moving towards the out years (2013/2015), towards a personal health record that’s portable. As far as I know, that would be incredibly difficult to get to in 2011 for most health systems that are just dabbling with (Microsoft) Health Vault or Google.
It’s challenging. I mean, there’s 50 different pieces they put into meaningful use. I’d rather see five and some incremental depth around what must be done to receive these funds. If they did that, we might see real progress. For example, whereas we’re at 15 percent of hospitals doing CPOE today, it’d be great to be at 70 percent at the end of this, so you can say, “Hey, we actually did move the bar and moved the needle with the $20 billion we just spent.”
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