The Independent Institute


Will Congress Fix Its Electronic Health Records Fiasco?

There is some hope that Congress will fix—at least partially—the largely bungled Electronic Health Records (EHRs) deployment on which it has spent $30 billion since 2009. Doctors are very frustrated by EHRs, which interfere with their practice of medicine. The current government program to have them installed nationwide should be abandoned.

Tomorrow, the Senate will mark up a number of bills to remove the regulatory burden in health care. One of them will address EHRs. Will it help? Maybe a little. First, it would force the federal government to reduce the administrative burdens associated with EHRs. Second, it would force the federal government to defer to the private sector on interoperability.

Interoperability refers to competing EHRs communicating with each other. The health IT landscape is overwhelmingly complex, and it is unsurprising that the federal government struggles to create and implement appropriate standards for interoperability. A recent Government Accountability Office report surveyed 18 nonfederal initiatives to improve health IT:

Conversely, representatives from two initiatives said that current federal work on standards duplicates existing private sector efforts, and representatives from a third initiative expressed concern that the government is not flexible enough to account for changing technologies and should therefore leave this issue to the private sector.

As for MU*: “Representatives from 10 of the initiatives noted that efforts to meet the programs’ requirements divert resources and attention from other efforts to enable interoperability.”

(*MU refers to Meaningful Use, the federal program which pays doctors and hospitals to install EHRs.)

In other words, federal intervention presents a distraction from the priorities the health IT workers on the ground think are more important. It would be good for the federal government to get out of the way of health IT.

On the other hand, the bill proposes a system of star ratings for certified health IT. The system would have at least three stars, and vendors achieving only one star would be subject to warnings and fines. The star system would be governed by a new agency, which would set and enforce the standards.

It is difficult to see the benefit of such a system, which would establish a new bureaucracy and requirements on vendors which might well exceed or be different than those demanded by their customers.

Overall, this bill suggests Congress has become a little more humble with respect to federal control of Electronic Health Records.

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