Meaningful use: Its time is coming
In a November Congressional hearing, National Coordinator for Health IT Farzad Mostashari, MD, told the Subcommittee on Technology and Innovation that the implementation of meaningful use was meant to be challenging. "This is a long road," Mostashari said.
Mostashari is a true champion in the fight to ensure effective use of IT in the healthcare community, and I agree emphatically that the road to real sharing of information is a long one. But from the standpoint of provider adoption, meaningful use compliance, while time-consuming, is in fact very simple. I have seen it in the practices that I deal with every day. I believe MU sets the bar for better and more open care coordination, and I have already seen it result in more positive outcomes for patients across the country. Going forward, MU can lead to prompter access to medical records, less redundant testing, and fewer medical errors.
If we stop and think about it, meaningful use is really just a new infrastructure for tasks we already do every day as providers: sharing information and documenting treatment histories. These tasks can be done much more efficiently, using the same technology found in nearly every other sector in the United States, both public and private. The potential results are clearly in this nation's interests: lowered costs and improved outcomes.
Meaningful use is still optional until 2015, but it isn't going anywhere. Plans for Stage 3 of MU are already under way. Providers all over the country and the staffs supporting them are fast learning the benefits of sharing information freely over an open platform. In fact, the latest survey released by the eHealth Initiative reveals that health information exchanges are making significant progress in sharing electronic data among providers.
Despite the efforts of some states, more data are being exchanged and more HIEs are becoming operational.
Consider the latest statistics: According to Mostashari, the adoption of EHRs with meaningful functionalities has increased significantly. Between 2008 and 2011, the percentage of office-based physicians with systems that meet the criteria for a basic EHR doubled (from 17 percent to 34 percent), and hospital adoption leaped almost threefold from 13 percent to 35 percent.
The assumption that any stages of the MU rule will be unwound or repealed anytime soon is increasingly unrealistic. Bundled payments and pay-per-value are now a fact of life, and the current five-year exemption based on specialists' relative lack of face-to-face time with patients and need to follow up will only last so long. In fact, these exemptions are subject to annual review, so there is no guarantee that they will continue to be accepted by CMS.
But even in light of these realities, questions remain. Key stakeholders such as the American Medical Association and the American Hospital Association have expressed concern about the Stage 2 meaningful use requirements. Specifically, they are concerned that certain specialists may be required to invest in systems and electronically record data that may not apply directly to their provision of care.