Barely mak­ing the grade

Feds re­ceive mixed marks on IT ini­tia­tives, an­nual sur­vey shows

Modern Healthcare - - Special Feature -

Many of the de­sign­ers of the fed­eral gov­ern­ment’s health IT in­cen­tive pro­grams have at­tended med­i­cal school, law school or grad­u­ate pro­grams in busi­ness, pub­lic health and pub­lic ad­min­is­tra­tion. They’ve earned M.D.s, J.D.s, Ph.Ds, MBAs and MPHs.

But if they had to rely on grades from our read­ers for their per­for­mance as IT pro­mot­ers, they wouldn’t be mak­ing the dean’s list this year.

Hos­pi­tal and med­i­cal group lead­ers gave some pretty hard marks to gov­ern­ment of­fi­cials of all stripes in a new sec­tion this year to our 21st an­nual Mod­ern Health­care/Mod­ern

Physi­cian Sur­vey of Ex­ec­u­tive Opin­ions on Key In­for­ma­tion Tech­nol­ogy Is­sues.

We asked two ques­tions about gov­ern­ment per­for­mance, re­quest­ing read­ers to is­sue for each a stan­dard letter grade of A through F.

When the marks came in, we con­verted them to num­bers and cal­cu­lated grade-point av­er­ages on both ques­tions, then cre­ated our own “re­port cards” for both.

The first, broader ques­tion was: “What grade would you give the fed­eral gov­ern­ment (in­clud­ing the White House, Congress, the CMS and the Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy) for craft­ing an over­all fed­eral ini­tia­tive to pro­mote the use of health in­for­ma­tion tech­nol­ogy?”

The sec­ond, more spe­cific ques­tion asked: “What grade would you give the CMS and the ONC for their per­for­mance thus far in de­vel­op­ing mean­ing­ful-use cri­te­ria that at the same time stretch goals and are at­tain­able?”

On av­er­age, read­ers gave gov­ern­ment of­fi­cials a solid C on both ques­tions. A C was the me­dian grade on both ques­tions as well, al­though hos­pi­tal lead­ers were a tad more gen­er­ous in their marks.

On the broader ques­tion, hos­pi­tal lead­ers gave the gov­ern­ment roughly as many B’s as C’s, al­though there were enough D’s and a few F’s to drop the broader gov­ern­ment’s GPA into the C range. Their peers, lead­ers in med­i­cal groups, were far stingier—giv­ing the gov­ern­ment marks on both ques­tions roughly half a letter grade lower than their hos­pi­tal coun­ter­parts.

Across the board, hos­pi­tal ex­ec­u­tives and med­i­cal group lead­ers cut the gov­ern­ment a bit more slack for “orig­i­nal­ity” in craft­ing the elec­tronic health-record pro­grams un­der the stim­u­lus law en­acted in 2009.

Both groups gave lower grades to the CMS and the ONC in fash­ion­ing and set­ting the height of the hoops providers must jump through to achieve mean­ing­ful use of an EHR and get paid un­der the Medi­care por­tion of the pro­gram.

Group prac­tice lead­ers were par­tic­u­larly tough on the CMS and the ONC in that re­gard, with 86% of those sur­veyed dish­ing out grades of C or lower, yield­ing a GPA of

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