Challenge of Meaningful Use Even for Existing EHR Users

Paul decided to stop by the post I did that referred to his comments on the skepticism around meaningful use. He shared a really interesting experience he had with a client that has an existing CPOE and EHR and their evaluation of the meaningful use requirements.

My point in my post on EHR and Meaningful Use is that providers ought to look at their organization and determine what they need EHR to do for them, not what they need to do to EHR to get a check—those are two very different business and HIT strategies.

One of my clients had already implemented CPOE and EHR. We assessed what they had to do just to meet Stage One MU requirements. Incentive dollars minus cost, to have the chance to meet Meaningful Use, left them upside down by five million dollars, and it would use eighty percent of their IT resources for the next three years.

If the organization is so quick to divest itself from the IT projects that would have been completed were there no Meaningful Use, what does that say for the planning that went into defining those projects? How much further down the ROI chasm should an organization be willing to fall to grab a check? To whom do these organizations ultimately have to answer—CMS?

Obviously, I agree wholeheartedly with his point of using EMR for the benefits of EMR and not for the stimulus checks (since I’ve repeated it dozens of times on this site). Use the stimulus money as a nice bonus if all goes well.

His comments also remind me a bit of my post, “Would Any Current EMR Users Be Able to Show Meaningful Use?

Don’t be confused. I’m completely PRO EMR. I can’t imagine clinics run without an EMR. I’m just still on the fence about whether showing meaningful use to get the EMR stimulus money is worth it.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • To be honest, I’ve never looked at EMRs in quite this way before. It reminds me of the time I sat down with an HVAC company to purchase new A/C, and we determined that, even though the government was going to give me some sort of rebate for buying an energy-efficient unit, it wouldn’t outweigh the initial cost of the unit or the supposed savings on my power bill the unit would provide.

    Thanks for the additional insight.

  • Jennifer,
    That’s a very good example. The challenge with this compared to A/C is that there are more than 25 variables (at least the 25 objectives of meaningful use) to do the calculation. A/C only has the cost savings. Add in the other EMR benefits and it’s no wonder we see everything across the board.

  • Paul’s advice to their client from the first paragraph of his post quoted above is excellent.

    Question for his client’s CEO would be whether their existing CPOE and EHR were meeting their corporate business and clinical goals. If so … that is real Meaningful Use from which further advances can be based. Government defined meaningful use standards establish a process of national mediocrity and provide no incentive by HCOs to advance beyond the Fed regulation.

  • Another area I would like to comment on is the belief that an EMR product eats up Emormous Money Reserves primarily because it has the word “Medical” in it. Before chosing an EMR you really need to analyze the requirements for exactly what would you like / need to accomplish for your practice, which a good project manager should be able to help you with.

    There are times the EMR product chosen is overkill but because “the big hospital down the road is using it” it is picked for a solo practice.

    Getting the HR factors, training and infrastucture defined and executed right are as equally if not more important than picking the EMR product.

    Some really good EMR products are free or under a $1K if they are implemented properly in the right situations.

    We have all read the horror stories of how poor implementations can cost you dearly in both money and undue stress.

    Dr. Peter J. Polack M.D. ( ) has an “easy read” book “Navigating the EMR Jungle” that can be a great guide to help you get started.

    Thanks for the great post and have a blessed day.

  • I am curious about the details regarding how the EMR implementation would leave Paul’s client upside down by five million dollars. Whew! The EMR vendors state how a practice investing in an EMR can recoup their investment in a few years. Is this more air?

  • Poly,
    I agree with you completely that there are now some really amazingly economical and effective EMR software for ambulatory practices.

    You have to remember that Paul is talking about a hospital EMR system. That’s where you can find this type of loss if you’re not careful. There are certainly many ways for a user to recoup their EMR investments. I’m not sure Paul’s exact calculations, but it is a fuzzy math. Some things are really hard to quantify with a dollar sign.

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