Final Rules are a big deal

HIT me with your best shot


A weekly post by Wm. T. Oravecz
WTO-Associates LLC

We have arrived.
Or, as VP Joe Biden might say, “This is a big … deal”!

The formal delivery of the Final Rule for Standards, Certification and Meaningful Use by DHHS Secretary Kathleen Sebelius; CMS Head, Dr. Don Berwick; ONC HIT Coordinator, Dr. David Blumenthal; Surgeon General, Dr. Regina Benjamin and Regina Holliday was done with real professionalism this week.

The work that this team coordinated to boil down the input of hundreds of technical subject matter experts (SMEs), healthcare providers, consumers, and other key stakeholders from public meetings, public comment through the National Committee on Vital and Health Statistics (NCVHS), the HIT Policy Committee (HITPC), and the HIT Standards Committee (HITSC) to culminate in an Interim Final Rule last January. Then, actively solicited comments on the proposal and receiving more than 2,000 in a 60-day period and with input from advisory groups and outreach activities and given careful consideration in developing the Final Rule introduced this week.

I mention this all since I’m not sure that folks in our market/practice/industry or the public always appreciate what goes into bringing about this kind of growth and maturity. In this case, implementing EHRs was identified as a national priority during the Bush Administration, which has been extended and funded by the Obama Administration through the American Reinvestment and Recovery Act (ARRA) of 2009.

This does not always happen. In the early days of digital medical imaging, advancement was stifled by lack of standards and rudimentary computerization. The problems were for the market to solve. It took a very long time and was eventually facilitated by the work of professional societies such as the Institute of Electrical and Electronics Engineers (IEEE), coordinating the interests of the variety of vendors interested in either getting into or attempting to control the market.

In the financial services industry, it was competition for accounts or assets in management that spurred the implementation of electronic trading and e-banking. Making investment and banking available anywhere at anytime drove innovation. Just think, I can deposit a check securely today with my iPhone through a global brand bank!

In manufacturing, it was operational expedience that spurred business process re-engineering in the early 1990’s giving rise to such enterprise applications such as SAP, Oracle or PeopleSoft.

However, despite the national agenda for EHRs, what I find most compelling are the observations shared by Dr. Regina Benjamin, a healthcare provider and Surgeon General in Finding My Way to Electronic Health Records and Regina Holliday, a patient rights advocate in her blog.