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Romney planned to change HIT standards development, end EHR incentives

What would have happened to the HIT standards development process -- and EHR incentives -- had the incumbent lost?

CAMBRIDGE, Mass. -- Had Mitt Romney won the presidential election, his administration would have ended EHR incentives and outsourced the development of HIT standards to vendors such as Epic and GE, said Beth Israel Deaconess Medical Center CIO John Halamka, M.D., the morning after.

Beth Israel wouldn't have changed its roadmap for adopting HIT standards and fostering clinical data interoperability between systems because Massachusetts' Chapter 224 state law -- among other influences -- would have kept the hospital on that track anyway.

It's a bipartisan issue, but the Republican position was that standards weren't developing [fast] enough.

John Halamka, M.D., Beth Israel Deaconess Medical Center CIO

However, Halamka had a keynote previewing meaningful use stage 3 at the Imprivata HealthCon 2012 conference the morning after the election and created a contingency plan in case Romney won. He contacted the former Massachusetts governor's campaign on the eve of the election, got the news, and created two sets of slides -- just in case.

"It's a bipartisan issue, but the Republican position was that standards weren't developing [fast] enough, and if we engage the vendors and let them solve the standards problem, we'd see huge acceleration in interoperability," Halamka told SearchHealthIT before the keynote.


Comparing his experience on health data standards groups, in which he participated during the Bush and Obama administrations, he said the Bush-era Healthcare IT Standards Panel (HITSP) discussions had more vendor bias -- and leaned toward codifying "what we do today."

In contrast, the current Health IT Standards Committee (HITSC) federal advisory panel more deliberately examines longer-term implications of its actions, he said, so that the U.S. health care system won't be stuck implementing data standards that could potentially become obsolete more quickly.

"It's more forward-looking [at] what is necessary from a policy perspective: How do we embrace Internet standards? How do we do things simpler and faster?" said Halamka, who enumerated the potential differences in a blog post on the eve of the election, admitting that he was wary of the Obama administration's HITSC idea at first -- but they eventually won him over. "Yeah, it creates a little pain for the vendors. But ultimately it will give us more functionality, it will make it easier to maintain, etc."

Attendees chime in on what could have been

Other speakers at the conference said that a Romney win probably wouldn't have changed their IT plans, either. Ed Ricks, CIO at the 197-bed Beaufort, S.C.-based Memorial Hospital, said that EHR adoption won't slow down at his facility. Even though he described federal EHR funding as "very critical" to Beaufort Memorial and its 23-person IT staff, there were no course alterations in the works had the incentive program been shut down.

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"We weren't doing any of this for meaningful use; we were doing it because we thought it was the right thing for our hospital and for the patients," Ricks said. "It wasn't going to change anything that we were going to do ... We'd already gotten two years of [EHR incentives], anyhow."

Imprivata CEO Omar Hussain said that although it was plausible that enforcement of federal laws such as HIPAA might have changed under a new administration, his HIT security company had not built any contingencies into its business plan. In his view, HIT adoption still would have kept advancing no matter who won the election. Moreover, health care providers would remain beholden to a host of state consumer and patient privacy protection laws either way.

"Meaningful use has accelerated the adoption of technology in the U.S.; it doesn't matter if you're Republican or Democrat, you're not going to solve the health care problem without embracing technology," Hussain said. "At the same time, patient privacy is still going to be a big problem."

He also noted that 20% of Imprivata's customers are outside the United States and that all governments where EHR adoption is taking place have some form of patient privacy rules in place -- and therefore HIT security will remain in the fore.

Let us know what you think about the story; email Don Fluckinger, Features Writer, or contact @DonFluckinger on Twitter.

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