A committee charged with analyzing last year’s report by the President’s Council of Advisors on Science and Technology (PCAST) has issued some preliminary steps for policymakers to factor into Meaningful Use discussions.

But given the scope of PCAST’s assessment of the current push for EHRs, as well as the urgency they cited for, among other things, the development of a Universal Exchange Language, it seems fair to wonder how much policymakers are willing to shift their current policy emphases in order to accommodate PCAST’s recommendations.

According to this report, the federal Health IT Policy Committee's PCAST work group “has come up with exchange uses that link meaningful use and the report from PCAST . . . where they intersect at the importance of engaging the patient.”

This “could include measures for the use and promotion of patient portals and direct access to their data in the next stage of meaningful use, (and) patient data could also be downloaded to a personal health record.”

These recommendations, along with comments made by work group members, indicate that the committee opted for, at best, a slow, incremental approach to incorporating PCAST’s ideas into current MU deliberations. Perhaps this is the best tack to take, given that the MU process is already well underway. At the same time, though, we can’t help but wonder about the willingness of policymakers to consider fully the implications of PCAST’s assessment given the desire to keep the MU process moving.

Or, as one former federal HIT official puts it, “the focus on the PCAST technology possibilities and the long lead-time specific technical approaches need before they can be considered part of regulation seem to have now boxed the broad recommendations out of Meaningful Use stage II.”

Our point is not to question the ONC work group’s specific decisions. Rather, it’s to point to the tension and potential for conflict that appear to be inevitable so long as federal policy is viewed as “driving” the HIT transition.

Put simply, it takes a long time to get policies in place, and once they’re in motion policymakers may be understandably reluctant to change them. On the other hand, there may have been oversights in the original deliberations, especially, in this case, as concerns the most effective technological paths to follow in order to achieve the best possible outcomes.

Obviously, policies of this scale can’t be stopped and started on a whim, but policymakers need to be willing to consider at least readjusting their overall timelines if the benefits to be gained by re-vamping current policies would lead to significantly better results.

Jeff Rowe blogs regularly at HITECHWatch.