After two weeks away from the office, I’m back in the saddle in Redmond. As much as I tried to pull the plug over the Holidays it was pretty hard to avoid the Christmas Eve health (insurance) reform antics gong on in Congress. If that wasn’t bad enough, the Office of the National Coordinator (ONC) on December 30th released a 556-page document providing interim final rules on meaningful use and qualified electronic health records. Reading even a summary of of the rules gave me a hangover greater than anything I’ve experienced on New Years Day. Is it just me, or are we only making everything about health, healthcare and the practice of medicine in America even more complicated and confounding than it is already?
I mean no disrespect to the politicians, industry executives, thought leaders and others who are doing this important work. But has anybody really stepped back and asked, “What is it exactly that we are trying to improve and how can we make getting and giving healthcare less complicated, more affordable, and more satisfying”?
I see glimmers of hope in some of the proposed rules. For instance, as a consumer I like the idea of being able to get a copy of my medical record in a timely manner. I applaud directives that take a more proactive, preventive approach to health. I really, really want my medical information to be stored electronically and shared (by my permission) with anyone who needs it. I want my doctor to be focused on providing safe and effective treatments when I’m ill and recommending things I can do to stay healthy when I’m not. But 556 pages of rules defining meaningful use of electronic records!
I think I have a far better than average grasp of contemporary information technology, electronic health record solutions, and hospital IT systems than your average Joe. Yet even I cannot help but feel overwhelmed when reading the ONC rules. As an average doctor in America, how many additional full-time staffers would I need to implement, let alone keep track of all this stuff. Would I be incented by an additional forty to sixty thousand dollars to my cumulative Medicare or Medicaid reimbursements to even bother with any of this? It might be easier to just withdraw from those programs as so many doctors have already done. Then who will care for our seniors and the medically underserved?
I can’t answer for my medical colleagues. I’m not in practice anymore. But if I was still in practice, I’m pretty sure these new rules would push me over the edge. And that’s coming from someone who actually enjoys using technology! And while we in America mire ourselves in all these new regulations and directives, will the rest of the world continue to innovate with much simpler, more pragmatic approaches to health IT? That has been my observation as I’ve traveled the world. Sometimes we are our own worst enemies.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft