Government // Leadership
11:02 AM
Anthony Guerra
Anthony Guerra

Guerra On Healthcare: Frustration With Meaningful Use Widespread

Healthcare IT executives would be wise to keep key players in the loop about industry-wide roadblocks to achieving Meaningful Use.

In the latest, but certainly not last, health IT Meaningful Use dustup, the industry is struggling to find clarity in (of all things) an Office of the National Coordinator for Health Information Technology (ONC) clarification. When that happens, you know you're in government-land.

This specific instance deals with whether hospitals are required to implement modules to address all 24 Meaningful Use Stage 1 measures, including the five that address things they're deferring to later stages under the Centers for Medicare & Medicaid Services' (CMS) Menu Set flexibility. Why -- organizations like the American Hospital Association (AHA) ask -- do hospitals have to buy and implement technologies they will not be using (at least not for now)?

In a letter to Department of Health and Human Services (HHS) secretary Kathleen Sebelius (copying ONC's David Blumenthal and CMS's Tony Trenkle), AHA president and CEO Rich Umbdenstock wrote, "this will delay many hospitals in their efforts to qualify as meaningful users of health IT."

The letter continued, "the lack of consistency between CMS and ONC, and the changing interpretation of rules when hospitals are in the middle of planning their meaningful use implementations, creates confusion and will likely delay the progress of hospitals working diligently to comply with the already challenging meaningful use requirements in a very short timeframe."

It closed, "we do not understand why CMS would provide an exception in these circumstances, but still require hospitals to pay for the acquisition and installation of the technical capacity to meet the objectives."

While the AHA, and much of the industry, doesn't understand CMS' actions in this case, you had better make sure your CEO, CFO, COO and board understand yours. I'm talking about taking care of the justifications (i.e., covering your backside or "CYA") that will become such a part of hospital CIOs keeping their jobs over the next five years.

As healthcare IT executives, you need to keep key people informed of all the roadblocks that come up as you move down the Meaningful Use path, whether they be thrown up by clinicians, the government or those key people themselves. If it looks like you're going to need more modules right now than you thought, they will have to be purchased and paid for. You must explain that situation to whomever holds the purse strings, including sharing both the ONC's requirements and the AHA's letter. They should know what you're dealing with, and that you're not alone.

If your vendor is unable to provide the certified modules for all 24 Meaningful Use measures, find out when they'll be able to, or starting looking for one-off sources to fit the bill. You can also check out CCHIT's new EACH program for self-certifying both vendor and home-grown modules. Through it all, keep everyone in the loop, whether they want to be or not. Put this information sharing in emails so you have a record. There is enough money on the line that, "you never told me we were in trouble on this Meaningful Use thing," may be heard around the industry over the next few years.

As the government works to clarify its clarifications, inhibiting your ability to move forward with confidence, spare no one your pain. Don't suffer in silence, and you may just get a pass if you fail to make the Meaningful Use grade.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at

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