Meaningful use didn't spark EHR uptake

Could the rise in EHR adoption be a matter of correlation to meaningful use and not causation? A new study suggests that might be the case.
By Jack McCarthy
10:40 AM
stethoscope on money and American flag

There will be government officials and health IT experts who refute these findings. Others, meanwhile, are likely to argue that it just confirms what they've been saying all along.

Here goes: There is little or no actual hard evidence to prove that the Meaningful Use program triggered an uptake in electronic health records adoption. That's  according to a new study published in the Journal of the American Medical Informatics Association.

The authors of "Impact of the HITECH act on physicians' adoption of electronic health records" examined the extent to which meaningful use and some $30 billion in incentives behind it influenced the EHR adoption curve that existed prior to the Healthcare Information Technology for Economic and Clinical Health Act of 2009, that being the legislation funding the meaningful use program.

"The authors find weak evidence of the impact of the MU program on EHR uptake," JAMIA explained. "This is consistent with reports that many current EHR systems reduce physician productivity, lack data sharing capabilities, and need to incorporate other key interoperability features (e.g., application program interfaces)."

It's a curious piece of research, particularly given that the Office of the National Coordinator for Health IT, on the public dashboard it maintains and elsewhere, has said that 95 percent of eligible and critical access hospitals have "demonstrated meaningful use of certified health IT. Through participation in the Centers for Medicare & Medicaid Services EHR Incentive Programs."

What happened, then? EHR adoption has indeed risen since meaningful use began, yet JAMIA determined that the federal reimbursement incentives are not the reason.

"The models suggest that adoption was largely driven by 'imitation' effects as physicians mimic their peers' technology use or respond to mandates," JAMIA authors contend. "Small and often insignificant 'innovation' effects are found suggesting little enthusiasm by physicians who are leaders in technology adoption."

Do you buy that? Is what we have here a simple case of correlation and not causation? Or much more complicated?

Related articles:  

Wait! What? Doctors like EHRs less now than they did five years ago 

EHR vendors uneasy about meaningful use certification 

DoD and VA: Interoperable EHRs when? 


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