Over the past few months I’ve tried to follow the dialog as to whether ARRA MU will continue to exist or be replaced with something else. I have previously blogged on a perspective that MU Stage 2 and certainly Stage 3 were finally getting to something meaningful relative to the ability to image-enable patients. Now, I have to wrestle with the notion of the rug being pulled out from under us before anything useful happens with respect to the patient and images.
For sure there are experts way beyond my knowledge on the merits of the ARRA MU system, and whether it has outlived its purpose. As noted in a recent article (http://www.healthcareitnews.com/news/31-health-systems-demand-stop-stage-3-meaningful-use-call-program-diversion?mkt_tok=3RkMMJWWfF9wsRonuqnBdu%2FhmjTEU5z16u4pW6O3g4kz2EFye%2BLIHETpodcMTcBnNbjYDBceEJhqyQJxPr3MLtINwNlqRhPrCg%3D%3D) thirty-one top-level health systems contributed to a letter to the Department of Health and Human Services urging a rethinking of moving forward with MU Stage 3. While noting the success of achieving a rate of over eighty percent of facilities using EHR’s, the group feels that moving to Stage 3 would not specifically improve outcomes, and is resulting in a potential drag on EHR design. Dr. John Halamka of Beth Israel Deaconess in Boston further states that the layers of requirements have become so complex that even the auditors don’t understand the regulatory intent (http://www.healthcareitnews.com/node/476236).
So, is this good news or bad news for imaging? As I stated above, my concern is that Stages 2 and 3 were finally getting to an impact on the patient. Dr. Halamka states that “Clinicians struggled to engage patients and exchange data because they could send payloads but there were few who could receive them.” My concern is not with the likely truth of this statement, but that it be interpreted as we are moving too quickly.
I would support the argument that the regulatory process is not producing good interoperable systems. However, there has to be some incentive for healthcare providers to push to implement such solutions. Granted, patients may be slow adopters today, but is it a chicken and egg scenario? Are patients not using the capability because the technology is not deployed, or because they don’t want what is deployed? I think the jury is still very much out on this one. As a recent patient last year, I can tell you from my own personal experience, I would love nothing more than to have access to my image data as well as lab and other study results on available technology such as a tablet or smartphone.
On the bright side, perhaps if there is less reason to push with more EHR reporting complexity, some of that energy can be invested in greater interoperability, both between healthcare providers as well as within. Investment that might have gone into new regulatory compliance can now be diverted to further system integration toward true clinical content management.
Perhaps imaging can take the lead, given that there are great standards in place and supported in the form of DICOM and XDS-I. If imaging can offer image-sharing solutions that enable easy patient accessibility, perhaps it could become a model for the rest of the industry. My only hope is that any change to ARRA MU doesn’t result in back peddling in terms of patient-enabled clinical content accessibility.