Somewhere down the road, Meaningful Use is going to reap dividends. If the program were going swimmingly right now, the Obama administration could take all the credit for having it implemented in ACA. Instead, it could continue into a new administration which would then likely reap the political benefits of its success, assuming that the ROI of Meaningful Use appears by 2020.
Another assumption is that the existing healthcare system doesn't collapse into a heap in the meantime.
"EHRs are like a utility. You've got to have one," says one healthcare IT consultant I know. But so far, we haven't been able to measure its return on investment in a consistent, predictable way.
This is like no utility ever built in the history of technology. Quality metrics are proving to be a tough thing to standardize across EHRs and providers. "Any decision to delay Stage 2 should establish clear expectations on [quality] standards harmonization," says Bill Spooner, CIO of Sharp HealthCare.
In fact, you could argue that incentive programs have institutionalized at the federal level proprietary EHR systems with currently inconsistent and half-baked quality measures. The question now is how do we make sure that when the last of the funding for Meaningful Use has run out—not that far off in the future—that we have truly open technology managing this country's healthcare information technology?
Where will the leadership come from to make that happen? ONC has been a cheerleader for the process, but it's not working out the way it had hoped.