The savvy tech strategy behind Obamacare

The ONC's Doug Fridsma explains why the health IT for EHRs and Obamacare should be like the Internet, and not like ERP or traditional IT systems

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Meaningful Use requirements: Why does it seem so hard?

InfoWorld: In talking to practitioners and IT people both, it's clear that there are a lot of issues they're confused by -- perhaps afraid of -- that we'd like to help them understand a little bit better. I'll start off with the Meaningful Use requirements. When I was at the HIMSS conference earlier this year, people were really wringing hands around the requirements, and from someone who's covered technology a long time, they didn't seem that onerous. I was really struck by that, so I wonder what I'm missing.

Fridsma: When it comes to establishing the criteria, the sort of the technical specifications that are required, we try to do that on a very open and inclusive process. We have our HIT [Health IT] Policy Committee and our HIT Standards Committee. We issue an NPRM [notice of proposed rule-making], then we get feedback from that and we incorporate that. In some sense,we've been pushing the industry, perhaps a bit more than it'd like to be pushed, to create the interoperability specifications that we need. We recognize that there's a lot of both our programs and other programs that are pushing the goal that having consistent, interoperable, and electronic means of sharing, collecting, and using information is important. So there's work with the Center for Medicare/Medicaid to implement new specifications around the standards for billing, such as the ICD-10-CM Codes -- an important aspect of that that I think the EHRs are working on.

We really do want to move beyond what have typically been siloed operations, and get to where the rubber hits the road. Interoperability isn't an easy thing, and I think you have to get it out there and start getting people to use it, and then refine that over time. We tried to address the right balance with this.

I think there are other pressures occurring. The kind of change that's occurring is really relatively quick. And I think there's a range of vendors. There are some that think that we've not pushed hard enough; they tend to be smaller, more innovative, newer companies. There are those that think we're pushing too hard because they've got legacy systems that need to be integrated and incorporate this information.

We've tried to hit that magical point where not everybody is perfectly happy, which means we've probably hit it about where we need to be.

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