Is the "meaningful use" race for $30-plus billion of ARRA stimulus funds finally about to get the green flag, or have increasing number of caution or red flags put the race on temporary hold? The answer seems to be a definitive yes, depending on who you ask.
Initially the race resembled a modern day version of the famous Oklahoma Land Rush, with participants jumping in with whatever kind of EHR vehicles they had in order to try to get their share of the stimulus monies. In an amazingly short time ONC and CMS published a dazzling array of detailed iterations of what "meaningful use" meant and how to comply, and it looked like nothing could stop the race.
But then in December 2010 the President’s Council of Advisors on Science and Technology (PCAST) issued its much-debated report that urged a major change in the government's current "meaningful use" direction, which it says "creates a danger that EHR adoption during early stages of meaningful use may exacerbate the problem of incompatible legacy systems."  It also urged ONC and CMS to accelerate the "aggregation of data across organizations," since "timely information derived from high-quality data should be at the center of efforts to analyze, understand and improve the health system."
Then in January 2011 a Stanford research report published in the Archives of Internal Medicine found that "despite the promise of better quality, the clinical benefits of EHRs and CDS (clinical decision support) are not evident in our quality indicators" and that "current patterns of EHR and CDS use do not appear to translate into better outpatient quality of care." Then suddenly there were other published studies that question the effectiveness of EHRs, such as a recent study by researchers at the Rand Corporation.
In February 2011, 39 different physician professional organizations urged "greater flexibility to meet meaningful use requirements," and agreed with the PCAST report by stating that "much of the infrastructure and the tools required to achieve the desired level of interoperability and information sharing remains to be built."
Finally in March 2011 the Advisory Board issued a report that stated that there is no financial advantage in pursuing "meaningful use" funds in 2011 versus 2012, thus suggesting that providers should reconsider whether to enter the "meaningful use" race in 2011 or wait until 2012 after the rules have been clarified.
So where does that leave the "meaningful use" race? I strongly believe that it's still a race worth running since properly implemented EHRs are indeed capable of substantially improving patient care, quality, safety, efficiency and cost. However, the caution flags raise very valid questions about the current direction of EHR "meaningful use," and thus healthcare providers would be well advised to get significant additional input before they enter the "meaningful use" race, which will require them to spend millions or tens of millions of dollars on EHRs since stimulus monies will only cover a portion of the EHR costs.
Rick Kneipper is chief strategy officer and co-founder of Anthelio (formerly PHNS).