I think this might be the million dollar question. Or I guess you might say it’s the $18 million question (depending on the EMR stimulus projections you like most). Think about it…
Would Any Current EMR Users Be Able to Show Meaningful Use?
Ok, think about the 25 meaningful use objectives (here’s a page with links to all the various meaningful use matrix out there). How many of the 15% or so of doctors who are currently using an EMR would meet the meaningful use guidelines?
I would say that the number likely approaches 0. If not, it’s extremely low I believe.
If this is the case, then why aren’t they meaningful users of an EMR. Is it because the meaningful use guidelines are off base? Or is it because these current EMR users need to step up their game and start using their EMR software the right way (or at least the meaningful use way).
This will give you something to think about this weekend.
Ankhos has most of those covered. There are easy ones like ‘record smoking status’ and harder ones like being able to make certain reports.
It’s not that a lot of the requirements are Hard, per se, just that a lot of them depend on external elements that are not under our control.
In some cases, they are also ill-defined. In our oncology office, chemotherapy is not filled at the pharmacy, it is delivered directly to the patient by a nurse. Neither the rx or the patient leaves the office before treatment most of the time.
Does our internal treatment management system count as CPOE? These are the types of questions they have to consider. The rules are woefully incomprehensive and need some work (at least with specialty practices) before they are actually meaningful.
Nick,
The point of this post isn’t so much if the EMR could do those things. Although, that’s an interesting question to (to which the likely answer is about the same). This question is more about the doctors using their current EMR according to the meaningful use objectives.
For example, I’m sure most EMR could ‘record smoking status’ one way or another. However, how many doctors don’t do that even though there’s the capability to do so.
Your point about the objectives being ill-defined is a great one and one that I’ve been preaching for a while. Too bad I don’t think HHS is going to give us much help in this area even once the final rule is published.
I tried repeatedly to recruit my own primary care physician for my REC. 3 doc IM practice, already live on EncounterPRO, since 2004.
That’s $132,000 in total MU incentive money on the table for the three of them, $54,000 in the first year (which they could be attesting for and submitting for by as early as April 1, 2011).
Not interested. Emphatically so. Not even with us there to put in place the EHR-specific SOPs tailored to drive them to each of MU documentation screens in the EHR.
Remember, a HITECH MU Certified EHR is one that has been officially deemed as capable of recording every MU criterion as structured data (even if the response is only “yes”/”no”). So, the onus then is simply on the providers to use the system in a way that complies. Many of the providers [1] see this as extra scut work regarding which they lack the time to engage, and [2] a large number remain dubious that the incentive money will even be forthcoming — can you say “PQRI”?
Amazing story BobbyG. Talk about an uphill battle. I just can’t help but wonder if the RECs shouldn’t start focusing on building the relationship with these physicians by providing some real unbiased, independent, valuable information for the clinic. Basically, a proof that they are working for the Doc and not something else.
Of course, maybe there’s just not time to do stuff like that.
Don’t mean to beat a dead horse, but if this stuff worked, we’d use it. No one on the front lines has ever heard of a REC or gives a hoot.
Up until the HITECH bill passed, EMRs were little more than a luxury for successful practices I think. Most have little knowledge on how to actually make them work for them, or even care about how to do so. I think the point that doctor’s aren’t using their EMRs meaningfully speaks to the fact that the vast majority of doctors have been using them wrong and/or inefficiently, not necessarily that the rules are off base.
And just to follow up, that isn’t to say that they are necessarily off base, but I will withhold judgement until they have actually been in use for a few years.
Many professionals are upset at the very fact there is meaningful use rules. I am willing to bet that no matter what the final rule was, the majority of those involved in this industry would be upset with them.
That last point is a good one. You’re probably right that no matter what the meaningful use rule was they wouldn’t like it. People don’t generally like to be told what to do.
[…] comment on a previous post described it well when they said, “I am willing to bet that no matter what […]