With $23 billion already spent on incentivizing providers to adopt electronic health records, many in government and industry are wondering whether taxpayers and patients got what they paid for. The heart of the debate: The Office of the National Coordinator for Health IT, its meaningful use program, and interoperable EHRs.

"What we've done is put in place a system that is forcing people into a square hole with a round peg, or vice versa, and maybe not even doing what needs to be done as it relates to patients and physicians," said U.S. Rep Tom Price, MD, R-GA, said at the Government Health IT Conference and Exhibition. "That's certainly what I hear back home."

An orthopedic surgeon, Price added that the current "mindset of top down" is missing the customers – the patients and the doctors – and ignoring important principles of the healthcare system he thinks the US should want: affordability, accessibility, and innovation.

[See also: Fear and loathing in meaningful use.] and [The man against meaningful use.]

Price laid down three ideas for fixing the meaningful use program:

1. Keep the patient front-and-center. "Sometimes there's this notion we need to put technology first," Price said. "Let me suggest we always, always have to keep the patient first, tailor the technology, tailor the innovation, so the patient has a higher quality of care, then we'll end up at the right spot."

2. Patients own their health data. "The technology exists," Price explained, adding that among the hurdles are patient privacy and protecting personal health information. "Understanding security has to be at the top of the heap," he added. "We ought to be able to encrypt things and make them function in a way that is viable."

3. Institute and require an interoperability standard. "I believe government does more than it should. But when it comes to interoperability, let's figure out what side of the road we're going to drive on, what color the stoplights are, what the signs say," Price said. "EHRs need to be able to communicate."

[See also: AMIA: Why interoperability is 'taking so darn long'.]

Part of the problem is that the meaningful use effort that came in the HITECH Act laid down a roadmap that Price said just doesn't translate so fluidly in the real-world.

The question of whether the industry will ever get to true EHR interoperability, arose in other conference sessions, with some suggesting that open source standards might work, others recommending that the Centers for Medicare & Medicaid Services pay more to providers who adhere to standards, and ONC handing more of the development work over to the private sector. 

"We are bright enough as a society to figure out a system that helps physicians and patients at the same time … if we keep the patient at the center we will get to the right answer on this and so many things as it relates to healthcare," Price continued. "I think this will get easier over time, but I promise you if we rely on Washington, D.C. to solely set the parameters we'll be behind the curve at every turn."

This article was first published June 18, 2014, on Government Health IT, sister publication of Healthcare IT News.