Making 'meaningful' strides

Measure for measure, we're better off than we were in 2010

Two years ago this summer, the meaningful use Stage 1 final rule was revealed to an eager public. Immediately, hospitals and physician practices got down to business. Since then, core measures have been tackled and menus sets have been ticked off lists. Some criteria were relatively doable, some have remained maddeningly problematic, but more than $2.5 billion in checks have been mailed out so far.

So it's worth asking: Two years into this massive undertaking, are we where we thought we'd be?

"Well, that's a different question than whether we're progressing," says John Hoyt, executive vice president of HIMSS Analytics. "We are progressing. But are we where we thought we'd be? I don't know that we had a cohesive vision of where we would be a couple years ago, but clearly the industry is stimulated by the program."

And how. "The industry is red hot," says Hoyt. "Consultants are able to be selective. There are projects they don't bid on. The CIOs are in a talent war  -  and not just for their employees but also for their contractors who bring people in who five weeks in disappear because they got another offer. It's hot. There's just no question."

But the goal of meaningful use wasn't to create consultant jobs or fatten vendors' bottom lines. It was to rewire a hoary healthcare system for the 21st century and beyond, using technology to help improve quality, lower costs and increase access. Have we accomplished that? Are we at least starting to?

"We are getting to see some consistent data that health IT investments improve quality and improve efficiency," says Hoyt.

Moreover, with the Affordable Care Act creating an environment where more physicians will be needed to treat more patients than ever before, the program has also set the stage for an industry that's attractive to a generation weaned on technology. "We have a young generation of physicians and nurses coming out of school with the expectation to have this technology," he says.

It's not often easy. The most successful adopters so far are the organizations you'd expect.

"It's the academic medical centers, it's the larger hospitals by bed-size, the hospitals that are more sophisticated," says Jennifer Horowitz, senior director, research at HIMSS Analytics.

The struggling and the stragglers are also the ones you'd suspect: smaller, rural and critical-access hospitals, and any number of small-shop physician practices.

Forward movement

Challenges are plenty. Hoyt says CPOE and most items that require the active involvement of medical staff are atop the list.