There’s been a really strong reaction to this post on One EHR Vendor’s Experience with MU Stage 2 certification. Although, Gabriel Perna pointed out that there was a lot of “I dislike” in the article and not enough like. Of course, part of that was because it wasn’t intended as a journalistic effort to cover both angles, but was a private response turned public. However, I was intrigued by the question of what Michael Archuleta, Founder and CEO of ArcSys, might “like” about meaningful use.
Here’s Michael’s response:
I REALLY like Context Aware Information.
I do like the idea that doctors have to be more timely on providing completed documentation.
I do like the notion that meeting MU provides a sense of continuity and expectations between doctors with different systems.
I do like the fact that documentation standards need to be lived up to within a practice.
I do like the fact that MU has already helped alert real patients to real problems.
I do like the fact that MU provides additional tools to help the doctor provide more information to their patients.
Wish my list were longer.
I recognize my “dislike” list comes across as a lot of whining. But, if there is no leadership or anyone willing to respond to my concerns, then the EMR community will struggle.
Plus, Michael added some more perspective to his previous comments:
Part of the frustration is that I spent 20 years of my life dealing with inconsistencies of the “standards” associated with electronic claims. Each insurance carrier would read the same rules differently and we, the vendors, had to code for zillions of contingencies.
Then the same thing happens with HL7 lab results.
Then we get MU and a whole set of “standards” and “rules”. It sounds like the same old song but on a different radio station.
What are we going to do when the SNOMED advocates feel their codes should trump Rxnorm or LOINC or ICD-10? When I talk with doctors about their understanding of these various coding systems, they are mostly clueless. If they balk at implementing ICD-10, wait until they meet SNOMED. Has anyone laid out the rules with respect to certification of when to use atomic-ids rather than concept-ids? These are but a few of the unknowns that people will encounter.
If I could have implemented and coded all the rules for MU2 before the final rules were published, then I could have asked real questions. But, there was no time, so now I live with the consequences. It is akin to the famous Pelosi statement, “You have to pass the law in order to know what’s in it.”
There is definitely a challenge in the rule making process. I really think that ONC takes the public comments very seriously. The challenging question is whether the right people are making the comments and whether the comments are informed or not.