“What’s in a name,” Juliet asked. “That which we call a rose by any other word would smell as sweet.”
Reading yesterday’s news from the Centers for Medicare & Medicaid Services (CMS), Shakespeare’s tragic young heroine might add, “And that which we call a skunk would still smell as foul.”
Seems that along with a proposed new rule that offers hospitals a break in administrative burden, CMS says it is renaming the Medicare and Medicaid Electronic Health Record Incentive Programs. The new name: “Promoting Interoperability.”
Sounds promising, right? One of physicians’ biggest complaints about electronic health records (EHRs) is that they don’t talk to each other. They’re not interoperable. And they should be. So that’s a worthy goal. But the name change isn’t worth any more than the pixels it’s written with until there’s some real action.
And like I said, yesterday’s proposed rule is all about hospitals. The eligible providers (that’s the group where CMS lumps in physicians)?
Not so much.
This marks the third name for this program in just nine years. First, it was “Meaningful Use,” which physicians soon started calling “Meaningless Use,” and then “Meaningless Abuse.”
They found themselves investing tens of thousands of dollars each to install EHRs that began to rule their lives like Hal in “2001: A Space Odyssey.” CMS required that check boxes be checked to satisfy the Meaningful Use overlords. Interacting with patients took a back seat to interacting with the mouse. As Hal told Dave when he asked the computer to do something practical, “I'm sorry, Dave. I'm afraid I can't do that.”
Sensing the hatred, then-CMS Acting Administrator Andy Slavitt declared in 2016 that Meaningful Use was dead. Did that mean the rules and regulations and required clicks were going away?
Not so much.
But we did get a new name. Meaningful Use became “Advancing Care Information,” as CMS introduced the even-more-costly, even-more-confusing quality measurement program under the Medicare Access and CHIP Reauthorization Act (MACRA).
A quick perusal of the 50 recommendations to fix Medicare that the Texas Medical Association sent to congressional leaders last week reveals that Advancing Care Information was no more popular, no more meaningful among physicians than was its predecessor. Among the recommendations:
- Eliminate arbitrary EHR requirements and allow physicians to determine how best to use their EHR.
- Redesign and overhaul certified EHR technology and enhance interoperability.
- Require EHR vendors to build and maintain products that meet all Quality Payment Program specifications rather than force physicians to purchase and constantly upgrade expensive and often-balky systems.
- If technology requirements continue for physicians, shift the burden of meeting regulatory requirements from physicians to the for-profit EHR and registry vendor communities.
So, do I believe CMS Administrator Seema Verma means it when she says, “Today’s proposed rule demonstrates our commitment to patient access to high quality care, while removing outdated and redundant regulations on providers”? Yes.
The intentions are good. The track record?
Not so much.
So welcome to our world, “Promoting Interoperability.” Goodbye, “Advancing Care Information.” We hardly knew ye.