CIOs celebrate end to meaningful use, want more details on future programs
Healthcare chief information officers breathed a sigh of relief on Tuesday when Andy Slavitt said the end of the meaningful use program was near. But many are waiting on the details before celebrating too much.
The acting administrator of the Centers for Medicare and Medicaid Services Andy Slavitt said in a speech at the J.P. Morgan Healthcare Conference that meaningful use would be replaced with a more streamlined regulatory approach in line with the merit-based alternative payment models of the Medicare Access and CHIP Reauthorization Act of 2015.
“I am still working with others to validate and understand his statements,” said Pamela McNutt, chief information officer of Methodist Health System in Dallas. “Is MU really going away or are the measures/penalties just rolling into the other programs and it is just semantics?”
Slavitt gave few details on Tuesday.
Paul Tang, MD, chief medical information officer at Sutter Health’s Palo Alto Medical Foundation, said he sees what Slavitt alluded to as “a natural transition from the carrot-and-push early phases of meaningful use to the payment-for-outcomes 'pull' of a reformed payment model that was made possible by the ACA and further shaped by MACRA – the Medicare Access and CHIP Reauthorization Act.”
“The early stages of meaningful use took the country from ‘zero to 60' in five years, a remarkable achievement that would not have been possible without HITECH,” said Tang. “Now, it's time for the new payment model that rewards providers for achieving better health outcomes to be the driver of innovation, using the new electronic infrastructure that is now in place. That was the vision for ‘Phase 3’ from the very beginning.”
Jim Noga, CIO at Partners HealthCare in Boston, welcomed the news. “Meaningful use has met its primary and important objectives and shifting from prescriptive regulations mandating EHR functionality to measuring its value and impact on patient outcomes is the right move,” he said. “This will also allow the healthcare IT community to focus its energies on innovation, interoperability, and initiatives such as patient reported outcomes, population health management and enhancing the patient experience and all that entails.”
George T. Hickman, CIO at Albany Medical Center in Albany, New York, blamed some of the recent frustrations with meaningful use on Washington.
"It's truly unfortunate, but I'm not surprised,” he said. “The lack of alignment in Washington, varied interpretations by our industry and its vendors, and the resulting and inefficient ‘MU clicks,’ as termed and borne by our physicians have led down this path."
“The sad part of it all is that MU was designed with best intentions yet fated by regulation and political interests,” Hickman added. “I hope we can somehow maintain traction on the agendas of true health data exchange and interoperability as well as patient identification standards as many provider and vendor colleagues continue to cooperate this work.”
As Craig D. Richardville, Carolinas HealthCare Systems CIO, sees it, meaningful use accelerated the industry's effort to transform and catch up with the rest of the modern digital world.
“We responded by making this transformation faster than any other industry,” said Richardville, who was just named the CHIME-HIMSS CIO of the Year. “As it progressed into the middle and latter stages, it has become clear that there is a disconnect between the government's requirements, the market's ability to deliver optimal solutions and the actual impact it would have upon our providers.”
Though well intended, the program’s later stages have caused some unnecessary frustration that could have been minimized if not prevented altogether, he added. Richardville agrees that merging certain parts of the meaningful use into MACRA is the way to go.
Health IT membership organizations such as HIMSS and CHIME released formal statements of support.
“HIMSS supports the use of information technology to enable our nation’s transition to a value-based care system,” said Carla Smith, vice president, HIMSS North America, in a statement. “As CMS begins to bring MACRA, MIPS (the Merit-based Incentive Payment System) and alternative payment model requirements online, we commit to continuing to work with CMS and the provider community to ensure the health IT foundation established, in part, by meaningful use is leveraged to improve the health status of all."
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Meaningful use “has had a profound impact on the adoption of health information technology and furthering the digitization of the healthcare delivery system,” said CHIME CEO Russell P. Branzell in a statement. “Members have long supported the underlying goals of the program and the industry has made significant progress in implementing IT systems to improve patient care, reduce costs and create a more efficient delivery system.”
He added CHIME would continue to push for better alignment of clinical quality measures and the adoption of enforceable standards as well as a laser-like focus on interoperability.
Branzell also noted that implementing a patient identifier is imperative, as are interoperable systems, a bigger focus on outcomes and a less prescriptive approach of how technology is used.