Stage 3 meaningful use ignores market realities, says Brookings

'Even if this miracle happens, we will not achieve much in terms of quality or efficiency in the healthcare system'
By Jack McCarthy
09:28 AM
Confused man at laptop

The transition to electronic health records is essential in modernizing healthcare – yet, in practice, meaningful use has made it painful and progress thus far has been intermittent.

Indeed, the proposed rules for the third stage of meaningful use, particularly the requirements for greater participation of doctors and hospitals, is now coming under even more fire than the program has seen in the past.

"Given the distance between the proposed rules of the meaningful use program and the reality of the healthcare market, the program's success should be considered a miracle,” wrote Niam Yaraghi, a fellow in the Brookings Institution's Center for Technology Innovation, in a post on the think tank’s site. "Even if this miracle happens, we will not achieve much in terms of quality or efficiency in the healthcare system."

[Related: New CMS rule may spark EHR uptake.]

As important as it is to have a successful EHR system, the one currently proposed is failing to live up to its promise and, what’s more, the meaningful use program does not anticipate that medical providers vary in nature and each operates in a unique environment.

Here’s the rub: Stage 3 of meaningful use for EHR implementation requires providers to send electronic summaries for 50 percent of patients they refer to others, receive summaries for 40 percent of patients that are referred to them and reconcile past patient data with current reports for 80 percent of such patients. If other providers do not send electronic summaries, however, the provider who was supposed to receive them will fail to meet the second and third requirements.

About a quarter of physicians have attested to the second stage of the program and are already sharing a large portion of their patients with other providers who were not able to meet the second stage of meaningful use and, thus, are likely unable to send electronic care summaries. "This leads to a situation in which even tech-savvy providers will not be able to fulfill the requirements of the third stage of the meaningful use program, regardless of their intentions and efforts," Yaraghi wrote.

Rather than force providers to exchange health information under federal regulations, they should be encouraged to invest in EHRs with an eye on the benefits of information exchange for patients, payers and providers.

"Ignoring the differences among medical providers," Yaraghi wrote, "and simply requiring all of them to attest to the same measures is not a smart policy."

What’s your take? Can the federal government tune meaningful use stage 3 to sync more effectively with market realities? Should it? 

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