11/29/2014    Alan Sherman, DPM

What's the Use of Meaningful Use (Jeffrey Kass, DPM)

Jeff Kass’s comments regarding the billions spent
(19 billion in 2103 alone) on payment to doctors’
offices for accomplishing meaningful use was quite
poignant and insightful. I have said again and
again that we missed a huge, important opportunity
when the ACA failed to establish interoperability
and communications standards for EMRs. The
network effect, whereby data gains enormous value
when it is put on a network and made accessible,
was totally missed in this legislation.

It’s the 21st century, but we’ll still need to
print and fax, or at best, send static PDF pages
of our medical records when requested by another
office, for a few years more. It's funny how we do
things in America. We left the development of our
healthcare system, that system essential to
quality of life for all citizens, to industry.
Rather than set firm standards, we left it to the
insurance industry and big medicine. And industry
is selfish, existing not for the greater good, but
primarily to maximize shareholder value.

Why would HCA want to share its data with Mayo or
Scripps? Just because it would save more lives and
improve quality of life? Nah. They’ll never
voluntarily agree to do it. They want the
advantage, they want to compete. They’ll have to
be required to, in subsequent legislation. Make no
mistake – these large health delivery systems that
maintain standardized connected EMRs within their
system will be mining the data to improve
outcomes. But only for THEIR patients, within
their system.

The ACA also failed to address another huge and
expensive inefficiency in modern medical delivery
– tort reform. Yes, Dr. Kass’s idea for the US
to develop a standard EMR for all doctors to use,
or at least a lingua franca, a standard data
standard so that all EMRs were compatible, is long
overdue and should have been part of the ACA.
It’ll be 3-5 years before we have this.

This article may be of interest to readers:
http://healthitanalytics.com/2014/11/24/leveraging
-healthcare-big-data-improve-population-health/

Alan Sherman, DPM, Boca Raton, FL

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