Purpose of EHR Incentive Program According to CMS

When I was reading through the EHR Certification flexibility final rule, I found a really interesting part of the rule (pg.49-50) that describes what CMS sees as the purpose of the HITECH act and all the money their spending on EHR software:

The entire overarching purpose of the EHR Incentive Program is to move providers towards advanced use of health IT to support reductions in cost, increased access, and improved outcomes for patients.

It’s been one of my pet peeves lately. People always come on this site or on social media and say “that goes against the purpose of the HITECH act.” I often would reply, “what is the purpose of the HITECH act?”

My problem with people’s comments about the purpose of all this spending on EHR software is that purpose changes depending on perspective. I’ve written before about the misalignment between “incentives” and “purpose.”

While I think the purpose for something changes based on whose perspective you’re talking about, I think it’s really important to know where CMS is coming from when it comes to the EHR incentive money and meaningful use. Now we know. They made it quite clear in the final rule.

How do you think the EHR incentive money is doing at achieving CMS’ purpose?

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

6 Comments

  • John,

    The sentence from the report you quoted somehow got cut off. The complete sentence is,

    “The entire overarching purpose of the EHR Incentive Program is to move providers towards advanced use of health IT to support reductions in cost, increased access, and improved outcomes for patients.”

    A laudable purpose, almost consistent with the Triple Aim, but not exactly.

    In any event, with hindsight it would seem the approach that was taken might not have been the best approach to “move providers towards advanced use of health IT.” Besides, what the heck is “advanced use” of health IT?

    In actuality, shouldn’t the purpose have been to advance the usefulness, usability and interoperability of health IT systems? Then, we might have actually had a chance to take a holistic design approach and define the specifications for a 21st century health IT infrastructure as opposed to trying to make last century’s IT systems do something they wern’t designed to do?

    It’s not too late. There is still time to start an alternate path/track of activity to define the next generation if IT systems to support healthcare. If we don’t do that, we’ll just have more of the same. More money spent, more frustrated providers and more patients being told they have to access the pt portal of every provider with whom they interact.

    Visit http://www.TheCUREProject.org. It’s a non-commercial, community based, program. We have a plan for stating out on the right path.

    – Bob Brown

  • Thanks for catching that Bob. Sometimes I get to quick with the copy and paste. I updated the post.

    I agree that the vision might be off and the execution towards that vision as well. Although, understanding their view is the first step to improving it and helping them understand why they may need to adjust their vision.

  • Glad I was able to help. If we can accept that the actions of all involved were based — at the time involved — on the best of intentions, then we have a chance to move forward with some corrective action. But we can’t play the blame game and I do not want to be viewed as doing that. I simply want better health IT systems.

    I believe we *all* recognize the importance of achieving the Triple Aim, but I also believe that right now, the quality and efficacy of our health IT systems and infrastructure are proving to be the gating factor.

    If we don’t radically improve health IT, I believe that those of us in health IT related business will be responsible for the failure of the community to achieve the Triple Aim.

  • Agreed John and Bob. I agree with John most of the times:) Having worked with the smaller practices for the past 5 years, I can see the change that the EHR Incentives and Mandates have brought about. In 2009, we had to sell the concept of EHR to the Physician, then to their Staff, sell the ‘Company’ and then the Product. Over time, EHR concept has become clearer and at least that does not have to be sold. The brand recognition for Health IT has been established and that helps a ton.

    Secondly – we are dealing with the top 1% of the educated professionals while dealing with the Providers. Without these incentives and mandates – resistance to change will simply be too hard to overcome. EHR Incentives at least made it possible to have 50% of the providers adopt EHR as of today.

    We consider the EHR in smaller practies to be the fundamental requirement of Health IT. With the responsibility of Care Coordination progressively moving towards Primary Care Providers and away from the Hospital and Institutional setting, its more important for Providers to adopt EHR and that’s what this EHR Incentives have mad possible.

    I agree we have miles to go before we reach the ideal Health IT setting; getting there is a process. Having participated with ONC on some of the Interoperability projects, I am convinced, they are doing the best within the constraints of working with a very educated population (Providers). Push them too much, and results may be harder to come by. Its one of the reasons for delaying the MU II. Eventually we will get there; there will be bumps along the way; for a massive project like this – its to be expected. This is bigger than the Banks going electronic – which started in the early 80s and only in the past decade were we able to do everything online. In healthcare, the start was made in 2010 – ………………..

  • Recently CMS has also introduced a flex IT act rule in which the reporting period is being reduced from to 90 day period instead of a full year reporting. This will help the physician as they have been looking for a shorter reporting period.

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