As for CCHIT\’s longer-term role, I believe that the federal government needs to step up and establish substantive standards and corresponding certification criteria. There are some things that simply cannot (and should not) be accomplished in the private sector. And, this time around, there may (I said MAY) be enough political will to get something accomplished.

In terms of the aggressive timelines in the stimulus package, the fed will need to act quickly and decisively. The fed could certainly adopt some of CCHIT\’s existing certification criteria, as well as develop additional meaningful criteria, but only after the most sensible standards have been established. Standards first, then certification criteria. If sufficent progress toward standards and certification has not made in the coming months, the \"meaningful EHR user\" reimbursement schedule could always be moved back (delayed). There has been much discussion about \"cart before horse\" with the HIT portion of the stimulus bill, and I for one agree that we won\’t get the greatest value from the $20B to be spent unless we have a meaningful end game in sight. Spending dollars to merely to increase the overall size of the mish-mash of existing dysfunctional HIT components won\’t help anyone in the long term.

After the fed lays down the law, then we will start to see some real progress toward increasing efficiencies and saving health care dollars. The various health care players, including EMR and related app\’ developers, public- and private-sector payors, providers, TPAs, etc., will have their marching orders. We\’ll see greater competition among EMR and related app\’s providers, and the pricing will come down. All EMR providers have been wasting money chasing the standards tail, and many smaller providers have not been able to carry through the trumoil and gain traction for their offerings, forcing them to go out of business or merge with a rival. In my opinion, fed-mandated standards (and corresponding certifications) will level the playing field for many health care players and start to move us in the right direction. Not a panacea, and with much more work to be done and many tough decisions to be made, but a clear step in the right direction.