Evaluating the current state of meaningful use

Lawmakers established Meaningful Use to spur greater adoption of electronic ealth records (EHRs), but questions about changing requirements and deadlines as well as the future of the program have many practitioners struggling to move forward.

            Last October, the Centers for Medicare and Medicaid Services (CMS) released changes to the program went into effect last year and will continue through 2017. CMS modified the Stage 2 requirements, in response to overwhelming concerns that the goals were too onerous for many eligible professionals (EPs).

Then, just a few months later in January, Andy Slavitt, MBA, CMS’ acting administrator, created a stir when he announced that Meaningful Use would be replaced, as CMS moves toward payments based on outcomes instead of services.

Slavitt and Karen DeSalvo, national coordinator for health information technology and acting assistant secretary for health at the U.S. Department of Health and Human Services, quickly clarified that changes to meaningful use are forthcoming, so physicians should stick with the current program.

            Still, the Stage 2 modifications and the uncertainty about Meaningful Use’s future have left many clinicians believing the program is an expensive moving target that’s hard to hit.

Not only has that bred frustration, it is, in some cases, prompting clinicians to abandon their pursuit of certified EHR technology as defined under Meaningful Use.

“Stage 1 [of the Meaningful Use program] was pretty successful. But as we transitioned into the second stage of the program, that’s when the problems started. It was very evident very quickly that EPs wouldn’t be able to transition quickly to Stage 2,” said Robert M. Tennant, MA, director of health information technology policy at the Medical Group Management Association.

In addition to keeping up with changing CMS requirements, many clinicians face challenges in finding and implementing the best technologies to fit their needs, training staff on new systems and using new technologies in ways that helped, rather than hindered, patient care and administrative tasks.

“And at the end of the day, what’s most frustrating is that physicians don’t feel that the level of patient care is improving,” Tennant said.

            Given such challenges, some clinicians are determining that the investments required to meet Meaningful Use standards don’t make financial sense any longer.

“You’re going to weigh the benefits against the cost,” Tennant said. Some practices are doing the math, seeing, for example, that it will cost $20,000 to prepare for MU vs. $4,000 in penalties levied on their federal reimbursement.

“That’s not the purpose of the program. The program has to encourage the physicians to adopt the technology,” he added.

            But even at practices that have abandoned Meaningful Use, they and the broader healthcare community continue to advance their rates of EHR adoption and use. Clinicians and institutions are doing so not necessarily to be MU, but because health IT can make a difference in clinical care, said Patricia Wise, RN, , FHIMSS, vice president of healthcare information at the Healthcare Information and Management Systems Society (HIMSS).

“They’re just not doing it to the government requirements,” she said. “They’re providing outstanding quality care, but they’ve moved away from providing the data the government requires on Meaningful Use. They’re moving forward with technologies they think are more applicable to their populations.”