All of us!
Every single one of us that participated in the technological “revolution” of the healthcare system.
This list is comprised of the government or CMS, EHR vendors, healthcare standard development organizations, healthcare standard harmonization efforts, medical associations, media, independent healthcare IT professionals, me, etc.
All of us!
In one way or another we are all guilty of the outcome: the technological destruction of the USA healthcare system.
I clearly remember when I was supporting Meaningful Use in late 2009, and I had also fervently supported the transition towards ICD-10 around the same period.
And now, in January of 2016, it’s practically been announced that the putrefied corpse is actually dead. It was dead right after MU1 because the committee planning of MU2 took so long and it failed to recognize that it was not aligned to MU1.
The bar for MU1 was so low that an alley cat could get a certification for an EHR. For MU2 certification its been an impossible feat even for the bigger vendors. Many of us noticed this and we were outraged.
Of course MU3 is being cancelled since MU2 has been a disaster in implementation and adoption.
I recall when in 2012 I wrote a blog post about the intent of the AMA in halting ICD-10. I would have been supportive to delay it or to further organize it, but to halt it?
Although they succeeded in delaying it they never addressed the problems that were inherent to the ICD-10 coding. Nobody addressed the banalities. The coding system isn’t to blame, it’s the way it was implemented that was downright mediocre.
But at the end, even though it was delayed, nothing was done to fix the reasons it was being procrastinated. At the end the CMS simply decided to receive whatever was sent across the lines and not impact the reimbursement. Really? You can never win one against Uncle Sam. (So Doctors, just be careful because over-payments from CMS will have to be payed back when you least expect to.)
Many years after 2009 we realized we really didn’t have interoperability standards. Even the most qualified healthcare interoperability experts of HL7 indicated that HL7 v2.x had served it’s purpose and that v3 was too complicated. A small group of well intended HL7 members started promoting FHIR. FHIR is more of an API that leverages the latest web technologies than a standard. It tries to build on top of the standards they themselves have claimed to already have served its purpose or to be too complicated. Go figure. But this came to incubation way too late. FHIR is still only a nice prototype which they call a DSTU. It may take years before FHIR becomes a full-fledged standard.
So CMS created the interoperability roadmap without an interoperability standard in place.
Interoperability without a universal patient identifier and a universal longitudinal electronic health record is a two point unicorn.
We have to fix this!
Where are the courageous?!