“To the Victor Goes the Spoils”

The 8 Commandments of Meaningful Use Penalties for EPsCommentary by Jim Tate
Twitter: @JimTate

I love that sentence, “To the Victor Goes the Spoils”. Sounds like something Julius Caesar would have said but the phrase can actually be attributed to a New York senator and was uttered in 1831. We know what it means and it can be expressed in many ways. I like the way Pope Leo X said it after learning he was selected, “The papacy is ours. Let us enjoy it”.

This story is as old as Time itself. In recent times the process has become refined to a royal art. It goes like this: the princes of an industry capture the ear of the King. The King is “educated” that a particular endeavor would benefit all the commoners and should be supported by a series of incentives. The Court approves the plan and the princes have a head start as they helped develop the entire idea, which was theirs in the first place. Princes get rich. Repeat. If something doesn’t work out for a particular prince they can always seek out the King’s ear with another plan than is incentivized (solar energy?). If, during this little drama, the commoners see benefit, so much the better. This is the process that made the Hudson’s Bay Company, founded in 1670 by English royal charter, one of the richest and most powerful corporations in the world. This is also the process that influenced President Obama to include the EHR incentive program in the “Stimulus Bill” in 2009 when the sky was falling. In the crisis of the moment the EHR industry was given a once in a lifetime gift without debate. The Federal government would essentially buy EHRs for every provider and hospital from private corporations.

Those of us who live in the world of health information technology, standards, and CMS guidance often keep our noses close to the ground. Rarely do we see the broader story that influences us all. One day someone will write a book that details the courtly behavior behind the EHR incentives but now is not the time. It is too early. Until then, gentle reader, I suggest you read a NY Times article: A Digital Shift on Health Data Swells Profits in an Industry.

Jim Tate is founder of EMR Advocate and a nationally recognized expert on the CMS EHR Incentive Program, certified EHR technology and meaningful use.