No one would have guessed how far and how fast the federal incentive program for the adoption of EHRs would grow. Funding was mandated in 2009 under the HITECH ACT, with an estimated total expenditure anticipated at $20 billion. That payout has already reached $9.2B in the program's second year of a five-year program.
Is this a 2012 Washington success story, or a travesty? Well, that depends on whom you ask. If you ask ONC chief Farzad Mostashari, you would get glowing adages of unsurpassed success, with an eye toward an even more glorious adoption rate in the future. If you ask certain fiscal conservatives on Capitol Hill, you would get a glowering eye and a resolved shake of the head. This is money that the government can't afford to spend, they'd say.
Added to this already wary outlook, GOP lawmakers are also distressed with what they fear is a lack of oversight to the MU incentive program. Are providers self-declaring their meaningful use correctly? Is there fraud under way?
Step outside of the Beltway, and you will be hard-pressed to find a physician practice or hospital system that has completed the difficult process of transitioning from paper to EHRs that is not fully convinced that EHRs don't improve care.
The federal budget is going to be the congressional battleground in 2013, above all other aspects of federal jurisdiction. Sparks are going to fly and figurative blood is going to be shed. Despite the landmark federal efforts made at lightning speed to overhaul a paper-based system, there will be some hearings on Capitol Hill calling for explanation and defense of the meaningful use program. There already have been some in 2012.
Does this mean there is a report card that can be made, for or against the MU program? Probably not. The program is riddled with problems yet to be resolved - privacy issues, interoperability, to name just two. But can the healthcare system continue to operate in the past, when the U.S. marketplace operates in an electronic world? Doubtful.
Some say the government didn't need to interfere; the market would have sooner or later forced adoption of EHRs. If you're a solo-practitioner, that might not have been for many years to come. Let's ask the small physician practices: Is the $9 billion payout for EHR incentives - so far - a success or failure?
