The Meaningful Use Sky is Falling

The always opinionated Anthony Guerra has an article up on Information Week that describes why he thinks the Meaningful Use sky is falling. Add that to a recent comment I got on a previous post that links to a Healthcare Data Management article talking about the potential repeal of the HITECH act and it seems worthwhile to assess the state of meaningful use.

I’ll start with the potential repeal of meaningful use first. We’ve known for a long time that the house was going to be going after healthcare reform once the republicans took over control of the house. In fact, we posted about the potential impacts to HITECH from the new Congress before.

I personally get the feeling that not much has changed on this front. I’m going to reach out to some of the government liasons for EHR vendors that I know that follow this even closer than I do. However, I still believe that:
1. The HITECH funding or at least the Medicare and Medicaid stimulus funding is safe from Congress. I’ve read this a couple of places and so I believe it to be true.
2. Any legislation that is passed by the house still has to pass through the democratic controlled Congress and avoid the Presidential veto. These two seem unlikely.

Of course, when it’s government work you could always be surprised by some loophole in the process that impacts funding or legislation. I won’t be surprised if one of these loop holes appears and affects the HITECH act. However, I still argue that if something does happen to HITECH, it will likely be a casualty of some other political agenda (ie. cutting whatever costs they can find) and not actually because they were specifically targeting HITECH.

Long story short: I still feel like the EHR incentive portion of HITECH is likely safe. Maybe some of the other funding will be cut short. We’ll see.

Now to the points that Anthony Guerra makes in his article. He describes the challenges that many hospitals are facing in regards to meaningful use. Plus he highlights the potential difference in the number of people who “think they qualify for the money” and those who “plan to apply.”

I might argue that if EHR adoption is the goal, then this might not be such a bad result. The idea of “forcing” meaningful use on people has always bothered me a little bit. Encouraging people to show meaningful use is only as good as the meaningful use criteria. If the meaningful use criteria is not very good, then do we really want everyone showing meaningful use?

For example, imagine that a doctor or hospital decides to use an EHR based on the EHR software’s ability to improve the efficiency of their office and the quality of the services they provide to the patient, but deems meaningful use as contrary to those goals. This seems like a great outcome to me. In fact, it seems like a better outcome than a doctor trying to force themselves into the meaningful use hole.

Obviously there are parts of meaningful use that can be very beneficial. For example, having an EMR that can communicate using a standard format (CCD for example) is important and valuable. If it is beneficial, then I see most doctors implementing these features regardless of whether they showed meaningful use or not.

One thing definitely seems clear from all the surveys and other stats I have: interest in EMR has never been higher. Whether that translates to “meaningful use” of a “certified EHR” or physicians meaningfully using an EHR of their choice, is fine with me.

You know my mantra: Select and implement an EMR based on the benefits that you and your clinic want to receive from the EMR. Don’t select and implement it based on a government handout. Those hand outs will be gone after a few years, but your EMR will be with you long after.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, 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, EXPO.health, 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.

8 Comments

  • John, thanks for taking the time to weigh the differing sides of Meaningful Use. In my opinion, the Spending Reduction Act of 2011 (H.R. 408) introduced on January 24 is a slippery slope for Rep. Jim Jordan (R-OH) and his co-authors. While, thankfully, there’s little hope for its passage, just the suggestion of repealing HITECH stimulus funds for physicians who can prove meaningful use of electronic health records is short-sighted at best and threatens the very progress that is already beginning to be realized within the industry to move our healthcare system into the 20th (yes, 20th) Century. All this bill serves to do is strengthen the cynics of health IT. The fact is that it’s actually putting doctors at greater risk right now, and for however long the discourse and debate over its validity drags out in Congress. Physicians inclined to wait out a decision be forewarned; the clock is still ticking on the EHR adoption timeline, and you won’t get to make up for lost time. Instead, you risk losing more money, as you’ll be farther behind in reaching your adoption goals. Let’s remember that there are very specific benefits for a medical practice from EHR adoption, both clinically and operationally. Improved healthcare outcomes will more than pay for the incentive dollars, and who is the largest payer of health care expenses in the country? That’s right – the federal government! We work with thousands of physicians and state government healthcare officials who have worked tirelessly over the past months to achieve the benefits that healthcare IT promises, and this bill is a disservice to them and to the healthcare industry.

  • Your blog is always good – but today and yesterday are just awesome! Way to filter through all the chatter on RECs, HITECH recalls and other firestorms.

  • I strongly disagree, Patti Dodgen. In the land of the free, providers should always be free to make the determination of what they purchase for their practice, and if they finance a product, they have an obligation to their patients to insist on a return on investment. EHRs simply cannot guarantee that even in hospitals.

    Even in the best of all worlds, Obama’s mandates have no more power than his political promises. For example, he mandated that Guantanamo Bay was to be shut down a year ago, and it just didn’t happen. In fact, there is now at least one Senator who wants to expand the facility.

    The so called EHR mandate will fail for very good reasons guaranteed by the Constitution unless eHRs are designed according to the needs of healthcare principals rather than healthcare stakeholders. God bless America.

    I am your cynic of health IT

    D. Kellus Pruitt

  • HITECH is clearly government pressure on an industry to move to a place not fully prepared, to use technology yet to be proven, which trade within did not identify as a business necessity, and with hopes of obtaining Pie in the Sky results.

    What is a House of Cards for $500

  • While you can certainly argue the benefits or lack of benefits of adopting an EHR, Patti is definitely right that if doctors get the impression that EHR incentive money could possibly be cut, that many doctors will delay or stop their EHR implementations completely.

    You can certainly argue that this EHR implementation delay or stoppage could be a good thing for the healthcare world if you want. However, it’s pretty clear that:
    1. EHR incentive money has encouraged many to adopt EHR software
    2. Possible removal of the EHR incentive money will discourage many from adopting EHR software and could anger many others who’ve already signed contracts.

    Emily,
    If I’m ever down, I’m just going to send you an email saying hi. I’m glad to hear you’ve enjoyed the posts.

  • John

    As usual , you don’t mince words. I totally agree that the providers should adopt EHR to better their practise and not for the stimulus money.

    I am sure the providers will agree that the way they run the practise is archaic. The practise should embrace automation to their own benefits and running their practise efficiently. Imagine those days, where you had to do all your banking at the branch and customers need to hold on to their statements for years or where you had to call your travel agents for booking a flight and all those cryptic airline tickets. Both the financial and travel segments have immensely attained efficiency and reduced their costs by automation. Embracing EHR in the long run is not only going to be benefical to the practise but the practise can actually cut-down their costs.

    Maybe, the adoption of EHR by providers should be drven by the the consumers of healthcare.

    So do not look at the stimulus money , adopt EHR for the inherent effcieincies it is going to bring to the practise and the consumers.

  • While HITECH has certainly created the “marketing buzz” to promote the industry prompting physicians into looking into EHRs for their practice (who wouldn’t want to get money from the government?!), it’s created so much confusion and frustration for physicians…and the punches keep on coming for providers with the red invasion of the House – more ambiguity…great.

    I will say that it is encouraging to see that at the state level (Medicaid Incentive Program), there seems to be some action that hopefully the Federal level will take cues from for the provider’s sake! http://www.simplifymd.com/blog/meaningful-use-medicaid-checks-are-going-out

    Incentives or no incentives however, providers should purchase and implement the EHR that meets their needs on all levels; from point of care to general workflow (and certainly certification if MU is a goal of the practice!). I like your “Selecting the Right EMR” guide that gives providers a glimpse into what items to consider when purchasing as you hit on all aspects of this.

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