When Meaningful Use Isn’t That Meaningful

As you know, I regularly like to highlight some of the best and most interesting comments on my various websites. Especially since I know many of you don’t read all the comments (shame on you). This comment on meaningful use comes from someone who identifies themselves as SoftwareDev and works for an EMR vendor:

Coincidentally, I actually came up with the exact same conclusion [see original post] when reviewing the specs the other day. What I mean is, I identified that the way that we track “problems” in our software serves our customers well, but doesn’t really meet the measurement method of Meaningful Use.

In my app, I can record a “problem” using an ICD-9 code on the patient record (chronic) as well as on the visit (acute/episodic, based on Dx attached to the charges posted for that encounter). I also track descriptive (non-standardized) phrases in our Medical History. The former is good because it meets the standardized terminology requirement, but it fails because I don’t keep a “history” of active, or inactive problems. The latter is good because it is more “all encompassing”, including problems that the patient isn’t actually being seen by this particular doctor for, but also fails because it isn’t recorded by ICD-9 code and descriptor.

Either way, I have to revise the software’s method of recording “problems”, both for historical purposes and for proper coding, and ONLY to meet the Meaningful Use requirement. Not a single customer has ever voiced a request remotely like this to me in my 12 years of handling software in this sector.

Descriptions like this is why I’m concerned about the impact of meaningful use. There’s little doubt that the EHR incentive money has stimulated interest and even purchasing of EMR software. I just wonder what unintended consequences will come from meaningful use and EHR certification. Sadly, the above description may meet meaningful use, but doesn’t sound like meaningful patient care.

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.

3 Comments

  • “I just wonder what unintended consequences will come from meaningful use and EHR certification[?].”

    You mean other than the expense of programming meaningless use funcionality bumps the cost of the box to the provider without providing anything of value to the practice of medicine?

    Just can’t wait for ONC to puke out ‘usability’ wickets.

  • @Don B-

    If the HIMSS11 “usability” presentation of ONC’s Friedman is any indication,

    http://www.himssconference.com/docs/sphandouts/ARRA2.pdf

    “End users of health IT will ideally form a seamless cognitive and psychomotor bond with the technology.”

    This is why “PhD” has come to be regarded as Piled Higher and Deeper. From The Health Care Blog:

    Much to the chagrin of virtually every EHR vendor at HIMSS (still far too many and I just can’t even begin to figure out how they all stay in business) Chuck Friedman of ONC announced in his presentation on Sunday that they are looking into usability testing of EHRs as part of certification process. Spoke to someone from NIST who told me this is a very serious consideration and they are putting in place the necessary pieces to make it happen.

    Maybe someone at NIST should whack this guy upside the head with their Nov 2010 Usability Guide:

    http://www.nist.gov/itl/hit/upload/Guide_Final_Publication_Version.pdf

    Usability is simply about 3 interrelated, overlapping, mutually reinforcing (for better or worse) concepts: [1] effectiveness, [2] efficiency, and [3] user experience. Task times to completion, sufficiency of the data captured, error rates, “cognitive load.”

    See pg 10 et seq.

  • BobbyG,
    I’d say that’s a pretty ineffective, inefficient and poor user experience PDF on usability. I guess you might say it’s an unusable PDF on usability.

    I really think it’s a bad idea for the government to try and measure usability of an EMR system. There’s too many factors at work in any given practice to know if one EMR is usable and another is not.

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