Yes, I’m still on my kick of asking the question of why we’re making the definition of meaningful use so complicated. Certainly I could make an ambitious goal of every doctor having to document everything granularly and electronically and share everything with everyone so we give the best care possible to patients. The reality is that if you do that, then no one will care about meaningful use and the EHR stimulus money will go unspent.
Certainly the above is a bit of an exaggeration, but I can’t help but ask myself if the definition of “meaningful use” isn’t so ambitious that the above will be the net result (at least for small practices) of the current definition of meaningful use.
It’s a little bit wrong for me to say it’s too complex, but not offer a plan. Here’s a real simple idea that should accomplish nearly as much as the meaningful use matrix presented by the HIT policy committee. It has 2 main areas of focus:
Data Interoperability – Establish a standard (since there isn’t a really good and widely adopted one now) including the privacy requirements that should be part of healthcare data interoperability. Then, require that EMR users show you that they can share the data from their clinics with other clinics according to that standard.
Reporting – Require that doctors be able to report data to HHS. Focus on receiving data that will improve the management of Medicare (since that’s what they should be doing with all this data anyway) and also data that will improve public health. HHS should be required to have plans on how it will use this data to accomplish each of these goals. Otherwise, why report it?
Why keep it so simple? Because you have to keep it so that you can actually measure that it’s being done. If you can’t measure it, then why have it as a requirement?
Plus, try to satisfy the above requirements without some form of EMR. It’s nearly impossible. If we truly want to increase EMR adoption, then ONC better be very careful about setting the bar so high when it doesn’t need to be.