Check out some really interesting quotes from David Brailer talking about the meaningful use definitions, ONC and the ARRA EMR stimulus money from healthcare IT news. My comments are in italics.

“It would have been easy to be symbolic rather than meaningful,” the founder and chairman of the San Francisco-based healthcare investor firm Health Evolution Partners said. He expected the criteria to “be looser, less meaningful.” Instead, he said, “I’m pretty impressed.”

I think I’d have preferred symbolic. I’d be interested to see something that shows how each of the criteria improves patient care and the efficiency of our healthcare system. Certainly a few of the measures have really great potential to provide some amazing benefits. Not to mention adoption of EMR software has many great potential benefits. Sadly, meaningful use might have been written SOOO meaningful that few solo practices will benefit from the stimulus. Of course, I might argue that this is the best thing that could happen to small practices. Now they can focus on implementing an EMR that works for their clinic instead of one that works for stimulus money.

Under ARRA, Congress provides incentives first and then penalties. Citing its track record with regard to Medicare issues, Brailer doesn’t believe Congress will follow through with penalties and will either delay or phase them out.

The problem, however, is that the Congressional Budget Office expects $30 billion in additional net bonuses over the next 10 years to come from the penalties.

This is an interesting comment about the proposed penalties. ONC/HHS is certainly going to need to consider what to do with these penalties. Will they start penalizing all these smaller practices despite making the meaningful use criteria prohibitively complicated for most? I’d hope not, but this is government.

Expect to see more fragmentation in 2011, Brailer said. “We’ll be approaching the peak of the hype cycle,” he said. He presages a “real slide back to reality,” with the money coming from CMS flowing “slower than everybody thinks.”

The pushback to reality is predictable and required with any hype, he said. Despite the challenges and problems ahead, Brailer said, “the problem isn’t whether we are making progress. We are.”

I really like this description a lot. A “peak hype cycle” which will “slide back” to reality. Reality always cuts through the hype. I do agree with Brailer’s final assertion. Progress towards electronic medical record is happening. Progress towards adoption of IT in healthcare is happening as well. I still believe that EMR adoption has been slowed by the EMR stimulus. However, the education that people have gotten thanks to the EMR stimulus may be the most valuable side effect of the EMR stimulus money.