John Halamka wrote some interesting comments about the various feedback he’s heard on the meaningful use guidelines on his blog. He gives some interesting insight into why ONC’s interim final rule is so vague (basically regulation/rule making mess). However, I couldn’t help but see how many times John Halamka used the words:

Need for additional guidance

This is no news to people like myself who’ve been writing about this since the beginning. There is a great desire for information on how to get the EMR stimulus money.

The real problem is that when things are vague and not well defined, then misinformation starts to take its place to satisfy our need for information and guidance. We want to be informed and so people start informing us even if the information is incorrect.

Today I got an email from someone stating that “We have the EMR already installed by a certified institution” and so they wanted to know how they could get the EMR stimulus money.

I felt so bad for this emailer. Someone (likely their EMR vendor) had either told them a lie about certification or more likely is that this person didn’t understand the details of the “certified EHR” component of the stimulus money. This is going to be a major challenge going forward as doctors who don’t have time to follow all the stimulus money movement get bad information. Plus, it’s only going to get worse if we continue to get partial pieces of information.

Sadly, most of the people emailing me about the EMR stimulus will continue to get the “Need for additional guidance” response from me. At least until ONC provides some additional guidance.

FierceEMR has really hit the healthcare IT arena in force over the past 6 months. They even have a big party planned for HIMSS. I’ll probably be stopping by since it’s the day after the New Media Meetup at HIMSS. Well, one of my favorite healthcare IT writers, Neil Versel wrote an article for FierceEMR that really caught my eye. It was titled, “Kibbe: New ONC standards make CCHIT process ‘irrelevant’”

If you’ve read this blog for any time you know that I’m an enormous fan of CCHIT (that was in the sarcasm font in case you couldn’t tell). I even declared the Marginalization of CCHIT back in July of last year. So, obviously I agree with David Kibbe’s assertion that the CCHIT process is irrelevant thanks to the HITECH act. A section of the article linked above describes some of the major problems with CCHIT:

Kibbe long has said the CCHIT certification process discourages innovation by being too complicated and costly for new, small companies that otherwise might shake up the EHR market with lower-priced, easier-to-use products. He also has held that the certification body was too closely tied to the health IT establishment. “CCHIT in effect acted as judge and jury for its own industry’s definition of EHR software, inhibiting alternative approaches that would embrace component or modular architectures, web-based delivery also known as ‘software-as-a-service,’ and practical means of achieving interoperable data exchange between applications from different vendors,” he says in a recent blog post.

No doubt the CCHIT criteria is no longer meaningful. The only problem is that a question still haunts my mind, “Did we just move the flawed process from CCHIT to ONC?”