As I have learned more about electronic health records (EHR), I have quickly become familiar with the term “meaningful use.” It sounds like a state of utopia, that everyone should strive for, yet like most governmental programs, it is much more complicated than it seems. Meaningful use of EHR technology is when providers properly “improve quality, safety, efficiency, reduce health disparities, engage patients and family, improve care coordination and population and public health, and maintain the privacy and security of patient health information.” Sounds like a pretty lofty goal, right? This is why Health and Human Services has divided the process into three stages, where eligible professionals and hospitals can receive incentive payments to help successfully implement the practices.
Stage 1 revolves around data collection and sharing, while Stage 2 helps advance clinical processes, and Stage 3 should end in improving outcomes. Once a provider or hospital meets the certain criteria required for each stage, they are then eligible to proceed to the next. Although Centers for Medicare and Medicaid have just released the Stage 2 criteria, the regulations will not be effective until 2014, even though incentive payments have already exceeded $7 billion. Therefore, Stage 3 will not be in effect until at least 2016. This seems like quite a long process in a field of health IT, which is constantly changing and adapting to new advancements.
It is undisputable that transforming healthcare into an industry that effectively utilizes technology is desirable, but members of Congress are starting to question if this burdensome process is the best course of action. Just this week, Senators John Thune, Richard Burr, Tom Coburn, and Pat Roberts have sent a letter to Secretary Kathleen Sebelius, asking for more clarification and explanation of the EHR system and the implementation of meaningful use. The Senators specifically ask about four main concerns:
- Does the use of EHRs actually increase utilization of diagnostic tests, therefore increasing costs?
- Are meaningful fraud cases being considered, such as hospitals accepting the federal incentive payments when they already had EHR systems in place?
- Have EHR’s increased billings to Medicare?
- Is there a federal plan to address interoperability between providers, since many adopt different EHR systems?
The last point is arguably most important, as we use billions of dollars to implement systems that cannot even communicate with others. Ease of access and transport are the most positive attributes of electronic data, and they should be the main focus of advancing healthcare IT. Although the stages of meaningful use have good intentions, its burdensome timeline and lack of inoperability seem to put healthcare providers at yet another disadvantage. Instead we need to focus on flexible solutions that lower cost, increase quality, ensure patient privacy, and utilize the best features technology has to offer.