I was very pleased to see that U.S. Senator Lamar Alexander is recommending the delay for Stage 3 of Meaningful Use, since it would drive the entire system to its knees. We all agree that the industry needed to change. This has been a bi-partisan initiative that started with President Bush and his appointment of David Brailer as the National Health Information Technology Coordinator back in 2004. For the past decade, this effort has been continued by the Meaningful Use program under the ONC.
I am not criticizing the initial goals of Meaningful Use (Stage 1 – Data Aggregation & Data Access; Stage 2 – Healthcare Information Exchange and Care Coordination; and Stage 3 – Outcomes Improvement). Rather, my extreme disappointment is directed to the fact that we did not pay attention to the first pillar – Data Aggregation and Data Access – to achieve outcomes improvement, which cannot be accomplished without clear and aggressive guidelines on interoperability requirements. Instead, the effort was directed to the implementation of EHRs for data entry, which created silos around few vendors. Of course, the consolidation and collaboration of healthcare providers that resulted from the Affordable Care Act (ACA) exposed the failures of Stages 1 and 2 around interoperability.