How the government shutdown limits health IT's impact

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As of this morning, the U.S. government is no closer to ending the shutdown, which has kept more than 800,000 federal employees out of work since last Tuesday. While the impact of the shutdown on health IT hasn't been front and center in mainstream press coverage, I think it's important to consider the following while thinking about the potential impact on both providers and patients:

  • The U.S. Department of Veterans Affairs last week said that the shutdown will reverse progress it has made on reducing its much maligned backlog of disability claims. As of the beginning of August, the backlog had been sliced to 496,000 claims, from 611,000 claims in March. The longer this shutdown lingers, the longer veterans will go without answers about whether their care will be covered.
  • While the Centers for Medicare & Medicaid Services has said that it will continue to accept and process Meaningful Use attestations during the shutdown, such efforts will surely be hampered with its workforce cut by more than 3,500 employees. That means more pain for providers, says FierceHealthIT Editorial Advisory Board member Stephen Stewart, CIO at Henry County Health Center in Mount Pleasant, Iowa. "CMS is slow enough as it is, let along any prolonged interruption," Stewart told FierceHealthIT last week. "If it is just a day or two, no big problem, but a week or more is going to spell chaos." The longer this shutdown lingers, the more rural providers like HCHC will continue to feel financially squeezed.
  • The U.S. Department of Health & Human Services Office for Civil Rights, which is in charge of enforcing privacy and security rules outlined by the Health Insurance Portability and Accountability Act, has been cut down from 221 employees to five, two of whom are in charge of "orderly phase-down and suspension of operations." The longer this shutdown lingers, the less safe patients will feel about the privacy of their protected health information.
  • ONC also has had to postpone all standards and interoperability framework activities, as well as all work related to privacy, security and clinical quality measurement, and administration of the Certified Health IT Product List. Many in congress already believe that Meaningful Use processes are too slow and difficult, that the program is a "waste of taxpayer dollars" or that it should the government should reassess the program. The longer this shutdown lasts, the more health IT policy work remains stagnant, only adding fuel to the fire for opponents of such efforts.  

Health IT isn't necessarily a mainstream topic, especially when it's put in the context of hundreds of thousands of out-of-work Americans. But the longer this shutdown lasts, however, the more its impact--or lack thereof--will turn into real, not hypothetical, pain. - Dan @FierceHealthIT