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Comment by dr_ | Hacker News Reader

Personally I don't think the 44K incentive has ever made any sense. All it has done is allow existing EMR providers to charge more for their poorly designed software. Physicians would have switched over on their own, if the reason were compelling enough - and that reason would be user friendly software at a reasonable price. Startups would have had more opportunities without the incentive. Now they have to offer it just to compete.

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One aspect of getting government certification is that all vendors are required to support government approved standards like HL7/CCR/CCD for the exchange of health information.

So forcing all vendors in the space to get certified has forced all of us healthcare IT vendors to cooperate and adopt a fixed set of standards for exchange of data. Without the government stepping in and forcing vendors to adopt these standards, the disparate vendors would never have agreed on any standards and followed them.

This is the type of industry that really needs that type of standardization and enforcement of it. I can fully understand why the government wanted to step in and help enforce that standardization for a greatest benefit of all involved, and I can not really think of an alternative to the cash incentive to get people to do it. Can anyone else offer up a reasonable alternative?

Getting certification and offering a $44K incentive are different things. I can understand the former being required of software companies - but the medical providers aren't the one who have to seek certification, they have to purchase the software and are being given an incentive to do so, because there isn't otherwise an obvious cost benefit for them to switch over. I feel the software company should provide the cost benefit for the medical provider to switch over. Free market competition, without incentives thrown in, would eventually allow that.

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