This is good timing and we knew this was coming along as myself and others have all pretty commented on the fact that CMS and the ONC are over their heads and that is not to pick blame as software builds on itself and we had a lot of modules and features added.  The additional modules were to make thing better, more complete, etc. but instead when you try to adapt verbiage to code that runs (which of course is what all EMRs do) you get back to the same old thing again with laws and rules that are legal verbiage centric but imagenot human model centric and always useable.  So add on layer, another layer later and again these well all good ideas and some additional intelligence documentation, but it grew and grew.  So how do you come around trying to manage all of this as when things grow with software, well it becomes more complex. 

We have all watched HHS and CMS blunder their way through Healthcare.Gov and just heard some wild stuff out of the mouths of data mechanics novices (and recently we heard it at the SEC too with Mary Jo White with markets not rigged) so it’s everywhere around in government.  So now here’s the AMA with a good list of ideas on how to fix some of this and it’s not bad at all as obviously you want to see doctors convert to electronic medical records but some of the folks out there today live too much in virtual values and lose track of the real world, which I call “The Grays”.  The AMA is trying to give forth some suggestions that focus more in the real world versus what has become pretty virtual as Meaningful Use is now and again all models don’t work in the real world as they do virtually.  It’s easy to get side tracked though when you work with data and forget the “real” world exists.  Doctors know it though as they deal with the real world every day and there’s a name for that and it’s called “patients”. 

I did think in fact that the one entry was interesting to where they recommend the mandated control of patients by physicians with electronic methodologies such as portals, apps, etc. so in this respect the AMA is telling folks is “People Don’t Work That Way” and you can see how a bit of “The Grays” took over here with the original provisions.  Happens all the time when a proof of concept from the virtual world doesn’t work in the real world.  I wrote several posts about former Secretary Sebelius getting duped and looking for a bunch of algorithm fairies too many times as data novices will get fooled every time and kept digging herself deeper into it.  Here’s what I said a short while back about broken software models and there’s a lot of them as software manufacturers too want to make a sale, which is not a bad thing but you need to look at your entire Health IT inventory before you jump, that’s for sure. 

“People Don’t Work That Way” A World of Broken Software Models That Don’t Align To the Human Side,Too Much Push At Times With Only A Proof of Concept That Fails in the Real World..

Will Meaningful Use 3 ever see the light of day?  Probably not in it’s current broken complex model as you will have people jumping out of windows as it would be insane to even try to build on this model; however if a new model that was simple were put together, and basically chucked a big portion of Meaningful Use One and Two it could work but again a brand new model.  AMA is also saying “test” some of this out before you put rules out to make sure the model works and be evidenced based. 

You see what I call nonsense “gamification” stuff out there and people are smarter than that by all means and I’m not talking about gaming to improve the response of the muscles and nerves in your hands type of gamification, that’s fine and that’s another subject, but rather the stupid stuff developers come up with to “dummy you down” to make you “think” it’s fun…put it out there for what it is and those are developers living in “The Grays” if you will as they think some virtual game will entice you to enter data into something.  So watch those folks with their virtual gamification crap as “people don’t work that way” and again treat people like adults and keep educating is the trick rather than try to use virtual world values for information that impacts and affects the real world. 

So this looks like a pretty good list and again nothing is written in stone so if you want folks to hang in with Meaningful Use and not drop out (as it is cheaper to do) then get your rules and regulations back into the real world and don’t be duped with some of the virtual values tossed out there as only a “proof of concept”.  About 2 years ago I said half of the analytics software was going to be a waste of investment and we are getting there today as there’s such a glut of it too, so be careful and wise with software and analytics today.  Get the good stuff.  BD   

The AMA advises:

* Replace the all-or-nothing approach to achieving meaningful use with a 75 percent pass rate to receive an incentive payment. “At a very minimum, this threshold should be used for at least the first year of each new stage.”

* Enable providers who meet at least 50 percent of a stage’s requirements to avoid a financial penalty. This encourages participation and demonstrates good faith efforts towards making strides to adopt and use certified EHRs.

* Remove the concept of “Menu” vs. “Core” meaningful use requirements and let providers implement the measures they believe are relevant to their practice and patient needs.

* Remove mandates outside of the control of physicians. Some technologies, such as patient portals and patient engagement tools, are not mature and the tools may pose a threat to the security of a practice’s EHR. Furthermore, successfully meeting requirements for patient use of the tools “lies squarely with the patient, not the physician.” Many patients prefer to speak directly with their physician rather than communicate electronically.

*Meaningful use mandates should be evidence-based before being put in the program. Requiring the meeting of criteria with little or no documentation and well-established evidence is wasteful and detracts from other well-documented methods of treating patients.


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