Regarding The Question Of Meaningful Use

It is no longer breaking news that during the recent J. P. Morgan conference in San Francisco, the acting administrator of CMS, Andy Slavitt, announced that Meaningful Use (MU) is going to be replaced in 2016 with, quote, 'something better'.

The questions this raises are too many to enumerate, but I think they can be boiled down to three basic ones: When? With what? And "What about my incentive payments?"

Unfortunately, nobody has the answers.

Mr. Slavitt Tweeted from the podium, "In 2016, MU as it has existed-- with MACRA-- will now be effectively over and replaced with something better #JPM16".

He offered little clarification. A complete replacement program? Or tweaks? Though he spoke well about the future, no hard facts were offered. Details to follow, was the message. That leaves the door open to wild speculation and guesswork. Again, nobody has the answers. That will not prevent the media from coming up with some interesting headlines.

Slavitt is only the acting CMS administrator. His announcement, while probably highly accurate, was perhaps also highly premature, unless the tearing down of Meaningful Use is already under way, as many wish. If that were the case though, I think there would have been more about it in the news, since it would be hard to keep a lid on something as big as this. No laws or amendments have been passed. Still, after dropping this not entirely unexpected bombshell, Slavitt went on to discuss in general terms the future direction the CMS would be pursuing in regards to technology.

Specifically, he mentioned a move toward rewarding healthcare practitioners for medical outcomes, rather than technological use. The technology behind EHR is now sufficiently robust to look after itself, in essence, so we should shift our focus to patients. Slavitt acknowledged that the MU program was implemented at a time when few physicians even knew what an EHR was. That situation no longer applies. Now, "It's time to make healthcare technology serve beneficiaries and the physicians who serve them."

He also spoke of harnessing interoperability to eliminate data blocking. On interoperability, emphasis was placed on introducing open API (Application Program Interface) hooks to allow better and more customizable access to medical data. An open API is a technical framework system that would provide software developers and vendors a standardized toolset with which to create new, faster, device independent apps which would offer users better access to a wider range of medical systems and to their PHI. How this could be achieved while maintaining PHI data security is another challenge, one which was not mentioned. Early days, of course. Writing as someone with a background in such things I have some understanding of the scope of this challenge, and I will only say "Bon Chance!" and cross my fingers to see where this takes us.

The driving force behind Meaningful Use was to drag healthcare kicking and screaming into the age of computers, and however you may feel about that, it has to a large extent achieved this task. As we said in our last blog, the technological advances which we have seen in the last five years are tremendous, and they will form a platform for future development. Perhaps MU has indeed run its course, and perhaps it does need to be replaced with something more relevant to the world of today.

What form any MU replacement program may take, whatever the disruptions that will happen along the way, and whatever the fallout from that transition will be, are all things that are pure speculation at this time. One thing I will predict is that it will be a rocky ride. Those news headlines will write themselves, I feel certain.

Perhaps the replacement for MU will be better. Perhaps not. Who knows? Not I. Time alone will tell. Tick. Tock. Until then, watch this space.


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