The Effect of the Meaningful Use Standard

The government is offering incentives for health care providers to promote the adoption and use of electronic health record systems. A study in Health Affairs revealed that although the initial meaningful-use threshold probably won’t have a significant impact, the later thresholds for the program will lower mortality.

Although the second threshold has a higher standard — using electronic orders for at least 60% of patients, compared to the initial threshold’s 30% — the authors suggest that it “would be more likely than the first-stage standard to produce the improved patient outcomes at the heart of the federal health information technology initiative.”

The government’s incentive payments may total up to $27 billion, but in order to be eligible health care providers have to prove meaningful use of the technology, not just that they have acquired it. Each hospital is eligible for between $3.5 and $6.1 million until 2016.

There has been debate over how beneficial electronic medication ordering is.

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Early studies have shown that most preventable adverse drug events were attributable to errors made during the ordering of medications and the transcription of orders,” the authors wrote. “They also found that the introduction of a computerized order entry system for medications was associated with significant reductions in serious medication errors.”

What authors Spencer S. Jones, Paul Heaton, Mark W. Friedberg and Eric C. Schneider found was that in stage 1, meaningful use could decrease deaths of hospitalized Medicare beneficiaries from heart failure and heart attack by 1.2%. In the second stage, meaningful use could result in 2.1% fewer deaths.

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We cannot conclude that the relatively low electronic medication ordering threshold embodied in stage 1 will lead to lower mortality rates,” the authors wrote. “However, our results do support the notion that the increased thresholds proposed for later stages have the potential to reduce mortality among hospitalized patients.”

Although the evidence for stage 1 was “discouraging,” the authors were still confident that when used more frequently, computerized provider order entry had the “potential to reduce hospital mortality rates.