Need for additional guidance…The Meaningful Use Mantra

John Halamka wrote some interesting comments about the various feedback he’s heard on the meaningful use guidelines on his blog. He gives some interesting insight into why ONC’s interim final rule is so vague (basically regulation/rule making mess). However, I couldn’t help but see how many times John Halamka used the words:

Need for additional guidance

This is no news to people like myself who’ve been writing about this since the beginning. There is a great desire for information on how to get the EMR stimulus money.

The real problem is that when things are vague and not well defined, then misinformation starts to take its place to satisfy our need for information and guidance. We want to be informed and so people start informing us even if the information is incorrect.

Today I got an email from someone stating that “We have the EMR already installed by a certified institution” and so they wanted to know how they could get the EMR stimulus money.

I felt so bad for this emailer. Someone (likely their EMR vendor) had either told them a lie about certification or more likely is that this person didn’t understand the details of the “certified EHR” component of the stimulus money. This is going to be a major challenge going forward as doctors who don’t have time to follow all the stimulus money movement get bad information. Plus, it’s only going to get worse if we continue to get partial pieces of information.

Sadly, most of the people emailing me about the EMR stimulus will continue to get the “Need for additional guidance” response from me. At least until ONC provides some additional guidance.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Sort of tosses the idea of calculating an ROI on Meaningful Use right out the window, and that doesn’t even account for the ‘guidance’ required for Stages 2 and 3

  • Paul,
    I think we still “need additional guidance” on the ROI question especially if you want to calculate the ROI for stage 2 and 3. Those stages “need A LOT of additional guidance.”

  • And that’s not to mention the possibly new flexibility that may be added to the NPRM, as proposed last week in the Health IT Policy Committee meeting ( One of the committee members rightly pointed out that this flexibility would add a whole lot of complexity to an already complex system. The real positive that came from the meeting was a desire to get Stage 2 guidelines out this summer as opposed to another year-end rule rollout. Of course, that’s just words at this point ….

  • Someone (likely their EMR vendor) had either told them a lie about certification or more likely is that this person didn’t understand

    We are now getting reports of “vendors” using this as a sales point PLUS now we are getting reports of certified vaporware being sold for $25,000 to $40,000 per doctor !!!!

    The problem here is the gov’t, Obama, did NOT think this through – say there are 300 EMRs if every single one certified even if there is only one organization to do it will have charge a minimum of $15,000 for certification to be in business more than two years. At that price less than half will certify so its $30,000 for which again half of those left which makes $60,000 etc.

    The ONLY way we will have “certified” EMRs is CCHIT – which is a dead duck for credibility – or total government funding for EMRs to certify – but this isn’t even being discussed, never mind any kind of agreement and funding initiative.

    This is a mess that will leave NO SOLO OR SMALL PRACTICE getting ANY stimulus funds unless they buy a hospital type bloatware system – again who will subsidize the certifying body to make the sale!!

  • John – you brought up a good point about misinformation out there. There have been multiple “rumors” about what is happening out there with meaningful use and the stimulus money. We, Nuesoft, decided to help address some of these with an upcoming podcast called “EMR Mythbusters”. It may be of interest to you and some of your readers to help dispel some of the mis-info.

  • John,
    Yes, that is correct. It is simple price /sales to profit /expenses. As price goes up those certifying go down vs a fixed costs basemant that is higher than any revenue generated anywhere on the price /sales curve because there is a limited total market.

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