Guerra On Healthcare: CHIME Says What It Thinks

The College of Healthcare Information Management Executives' letter to the Health IT Policy Committee shows it won't be relegated to ineffectual political correctness.
I've written before about how being "successful" in life isn't akin to running a marathon, but rather winning a series of sprints. These sprints are the opportunities that come along, and when we're talking about life-defining opportunity, perhaps that's once a decade.

When people talk about someone being lucky, what's usually the case is that the person has done much hard work to be in the right place with the right skills at the right time. They may not be master of the wind, but they've crafted the perfect sailboat and exercised a lot of patience.

This type of luck doesn't apply just to people, but also to organizations, industry groups and any other entity. Organizations, just like people, are tested by the times through which they move and, like people, they either rise to the occasion or shrink into insignificance.

I've been singularly impressed with the comment letters issued by the College of Healthcare Information Management Executives (CHIME) regarding proposed Meaningful Use measures.

To hit on another theme I've often brought up, you can either say something or say nothing. By saying nothing, I'm mean about putting out statements, releases and comments that really take no position whatsoever. These proclamations usually start with a line such as "Organization X applauds so and so for doing such and such." Nothing will spur my finger to the delete key faster than someone applauding or congratulating.

That's the weak end of the spectrum, but CHIME is on the other end. With its recent comment letter to the HIT Policy Committee about that group's proposed Stage 2 measures, CHIME has clearly shown it won't be relegated to ineffectual political correctness.

This line, for one, really caught my eye for its boldness: "MU criteria should not become a 'back door' means for the federal government to interfere with the practice of medicine." CHIME stated this as part of its argument against requiring extensive use of electronic clinical decision support rules in Stage 2.

Overall, CHIME wants Stage 2 postponed, cleverly, until 30% of eligible hospitals and providers can demonstrate they're using EMRs meaningful according to the Stage 1 requirements. This approach is brilliant because it will put the Stage 1 mandates to the test. It was less than a month ago that now-outgoing national coordinator for health IT Dr. David Blumenthal, was touting the number of providers who said they planned to apply for stimulus funds (mind you, that's not how many will actually apply or even qualify.) CHIME's recommendation will take all that sleight of hand off the table and really require the government to show that its Meaningful Use bar isn't somewhere in the clouds.

CHIME has chosen not to shrink from its responsibilities, not to merely applaud while bureaucrats who wish for change faster than reality hold ransom the money legislators intended for its members. It's fighting, really fighting to fix a program gone awry. I've written recently about the outsized influence some special interest groups have on the Policy Committee. CHIME is one group that should be at that table. What's clear is that whether or not ONC puts out a chair, CHIME is sitting down.

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 [email protected]

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