This was followed by a rambling talk by David Blumenthal, ONC, in which he stated that the ONC was encouraging “Meaningful Use” but would not get involved in the details of how any of this actually might happen.

This was much the same attitude from Brailer, essentially a political appointee with little experience in EMRs, but a lot of experience of pulling info out of claims-made data – an entirely different exercise.

The only conclusion one can draw is that EMR “industry lobbying”, once again has stalled any meaningful progress by end-users dependent on their vendors who have no business reason to make their EMR’s interoperable (the only good customer is a captive customer), and the clock is ticking to 2011.

it is quite apparent that CCHIT does follow the Golden Rule of Business – “He has the Gold makes the Rules.”

We also believe that the FDA should have recognized and regulated electronic medical records as medical devices from the very first contact with the patient. We can only speculate as to an actual number of patients harmed by faulty products. The real numbers are behind the veil of “learned intermediaries” and covenants of silence required by the end-user license agreements.

We also believe it is no coincidence that CCHIT continued to certify products that included this language. And we believe Dr. Brailer had a responsibility while he was at the Office of the National Coordinator to excavate this language and draw the necessary legal challenges required for regulation by the Federal government.

We believe Mr. Leavitt and Dr. Brailer have a lot of questions to answer concerning the negligence and willful continuance of this language that is counter current to the discipline required for improving patient safety and patient outcomes.

The data dictionary is important. However, the bigger question is creating a culture of reporting that is supportive and nonpunitive, the current “state of the art” for EHRs/EMRs containing exculpatory language requires regulation. It is a hoax to say these products are safe when the user is bound by such covenants. Putting a CCHIT certification on them does not make them safe.

We believe Senator Grassley has asked appropriate questions regarding this language and it would not be over reaching to ask Mr. Leavitt and Dr. Brailer, why they embraced and certified products that contain this language.

Business issues aside, I think CCHIT (and/or its successor) needs leadership that first and foremost knows how to build an effective EMR. Instead, my concern is that a prototypical business suit who doesn’t know their clinical IT a** from their elbow will take over.

Does anyone actruallly believe CCHIT is performing QA?

So, with a payment system that disincentivizes sharing of data and the consequent low priority of their customers for standards compliance, the fact that vendor systems do not implement standards is surprising in what way?

The private sector did exactly what was demanded of it, and nothing more. Realignment of incentives requires ditching the fee-for-service system cemented in place by….drumroll please…the PUBLIC sector. Namely Medicare and Medicaid.

It wasn’t until 2005 or so that Medicare stopped paying for certain types of medical mistakes, such as operating on the wrong side and leaving sponges in the patient.