The vice-chair of the HIT Standards Committee, John Halamka, MD, opened the first Standards Committee meeting by charging the committee with “recommending standards, implementation specifications, and certification…in support of meaningful use.” But “meaningful use” has not yet been defined, which begs the question—Are we putting the cart before the horse?
In fairness, the Standards Committee, as well as the other planners and implementers of the EHR provisions, are under significant time pressure to meet the ambitious deadlines contained in the Economic Stimulus legislation. The initial set of standards for EHR certification is due by December 31, yet “meaningful use” has yet to be clarified—David Blumenthal “hopes to provide a direction and some specifications in the late spring, early summer.” Therefore, in the interest of time, all parties are discussing “meaningful use” and standards concurrently.
To compound matters, it appears that the certification/standards decision has essentially been made already—underlying the conversations is the ubiquitous assumption that CCHIT will be the government’s standards for EMR qualification. Perhaps this is driven by the need for expediency in the face of the looming deadlines, or perhaps it stems from the recommendation made by HIMSS. (See last week’s blog below.) In either case, how can we already know what standards are necessary to ensure meaningful use before we have a clear and complete definition of “meaningful use”? How do we make certain that the standards are applicable to all physicians, including high-performance, private-practice specialists, when CCHIT standards are primary-care focused? Do we need another set of standards for specialty practices? In any case, isn’t this a classic example of putting the cart before the horse?
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