Physician Reaction to Meaningful Use

An EHR vendor recently got some bad news about a doctor who chose not to implement EHR. In the response, the doctor gave them this message:

“Meaningful use is the destructive component that all of medicine should be fighting as it clearly prevents the EMR from achieving it’s potential.”

My gut reaction to this comment is: He’s right.

I’ve often talked about how meaningful use and certified EHR have hijacked an entire EHR development cycle. That means that all 300+ EHR companies had the same development list for that time period instead of focusing on creating a broad variety of innovative solutions for doctors and patients.

I imagine some would argue that EHR vendors had a lot of years to create innovations and they fell short of doctors’ expectations and so meaningful use will get them to implement features they should have implemented long ago. In some cases, this is accurate. I actually love meaningful use stage 2’s focus on interoperability. A feature that should have been developed long ago and should have been. Although, on the whole I think we are missing out on a lot of potential benefits that EMR could provide an office because the EMR developers aren’t being allowed to innovate.

I’d also argue that our billing system has had that same effect on EHR. Instead of developing EMR software that will improve patient care, it was built to maximize reimbursement.

Going back to the doctor mentioned above. While I can agree that meaningful use diminishes the value of what an EHR could potentially provide a clinic, that doesn’t mean that the EHR doesn’t still provide value. That’s like saying that a $10 bill isn’t worth as much since with an extra 0 it would be a $100 bill, so I’ll throw out the $10 bill because it’s not providing all the value that it could provide if they’d done something a bit different.

At this point, I always refer back to my list of EMR benefits. There are benefits to EHR adoption beyond government handouts. Although, for some reason we get all crazy when the government starts handing out money and forget about other outside reasons to do something.

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.

14 Comments

  • While the doctor’s comment cannot be discounted in some cases, I believe that EMR vendors ultimately will find that they can make sure their clients remain MU compliant while still offering unique solutions for the field of healthcare.
    I believe our company and clients have benefited from the implementation of the Meaningful Use program not because we “fell short of doctors’ expectations” in the past and the MU gives us a second chance, so to speak. But by creating unique solutions to aid our customers in MU, we continue to satisfy current customers and have gained many new clients. This growth has allowed to increase our employee base to a degree where we can work on developing both solutions to MU as well as other features that will help physicians and their patients.

  • Brenna,
    You bring up an interesting question (great future post): Are all MU implementations created equal?

    I’d love to hear the top features you provide outside of MU that help physicians and their patients. What are your doctors favorite features?

  • Lack of innovation within the EMR industry has been the biggest disappointment and this omission places the consumer, once again, on the “back of the bus” rather than as a meaningful partner in our evolving healthcare system. Other ecosystems have visionaries and innovators creating revolutionary mobile health technology driven by consumer empowerment NOT the government. Our highly regulated and provider-driven US healthcare system will continue to be the most expensive and inefficient system in the world. How sad….

  • Thanks for the interesting post. I’ve also seen enhancement requests and upgrades postponed in behavioral health due to meaningful use. Very frustrating for those to whom meaningful use does not apply.

  • MU was meant to be the floor but turns out to be the ceiling and topping that most MU … isn’t.

  • Doctors were not buying EHR because they are resistant to change, their fear of computers, and they claim they don’t benefit from EHR.

    EHR vendors focused on throwing everything and the kitchen sink into their products, instead of working on usability. eCW is a prime example – what a horribly designed system. If the doctor has to cut the number of patients he/she see’s by 30%, that’s not acceptable.

    Both sides are guilty.

    MU pushes the doctors off of paper, and they have plenty of EHRs to choose from.

    EHR vendors must make their products easier to learn and use.

  • John,
    Most of our users cite our software’s customization potential as their favorite characteristic. Virtually all aspects of the EMR can be tailored to one’s specialty. The patient portal is an aspect that our patients love: it allows them to view their lab and test results from home, providing peace of mind. Stability is another aspect of our product that doctors value. Although important and useful updates are made, we try to keep unnecessary changes to the EMR format at a minimum.

  • Brenda,
    With regards to the patient portal when the patient transitions to another provider and/or insurance plan like all provider-driven EMR’s the patient no longer is “in the game” correct?

  • @PJ … Agree with the general direction of your post … but I believe you are off target on parts. Please excuse me if i misread your thoughts.

    As John and others have preached EMR usability is very important and while Stage 2 MU rewards some measure of usability by ONC’s definition … before that condition is relevant for a PCP the first priority is an EMR’s ability to contribute to improved clinical outcomes and enhance the gross margin through a positive ROI delivered inside notionally a five-year horizon.

    Absent achieving those criteria even good EMR usability should fail to attract a committed buyer. MU that stymies vendors from meeting the customers’ primary objectives not only impedes adoption but degrades the outcomes for those having to foot the bill.

    I think your statement … “Doctors were not buying EHR because they are resistant to change, their fear of computers, and they claim they don’t benefit from EHR” may be more urban legend or excuse from the mouths of HITECH vendors and government regulators.

    Doctors are not resistant to change when clinical outcome and practice business objectives can be achieved near term. The fact is the PCP population in general “don’t benefit from EHR” when measured against their primary criteria.

    Absent the token HITECH implementation incentive and HHS threatened “stick” practices aren’t interested in adopting technology that has no impact on near term clinical outcomes and reduces their clinic’s top line revenues. No matter how big a hammer or carrot ONC wields on vendors and practices if at the end of the day if the tire jack doesn’t work the flat tire will not get changed.

    Your point “If the doctor has to cut the number of patients he/she see’s by 30%, that’s not acceptable” may be a little high … but it is right on target. Any degradation is unacceptable as it violates first priority criteria.

    As for who is at fault …ONC is the major guilty party for the slow HEIT adoption rate. That’s what happens when academically or vendor-inspired regulators insert themselves into a market.

    The bottom line is that the right market-driven EMR applications will improve clinical outcomes and the practice’s margin but artificial and meaningless MU hurdles that regulators force into the box hinder most effective application deployment and outcomes.

    Ergo … we are making poor headway on what may well be the wrong path.

    I apologize if I misread some of your thinking … but certainly you are right on the impact of EMR on productivity.

  • Don B,

    I train doctors on different EHRs in New York City – Bronx, Queens, Staten Island. Some of the doctors I meet have never used a computer before. And these doctors are absolutely against changing the way they do things. It reminds me of their diabetic patients who refuse to try to stop smoking, or to eat something other than McDonalds every day.

    The doctors I meet everyday have deep fears of computers. They all fear that Medicare and the commercial payers will have access to their records. Most of the doctors absolutely beleive that documenting their patient’s history should be someone else’s responsibility. And if they make a mistake in the patient’s record, they won’t be able to go back and fix it like they can with paper.

    In a year from now, all the tech savvy doctors in nice zip codes will have gone electronic. The market will be left with the other 50% of physicians in bad zip codes who refuse to learn how to use a computers for something other than checking their stocks.

    This is the reality that ONC is not aware of.

  • PJ … “Some” doctors is less than your original post.

    Some might be resistant to change and some might fear computers. However, if rejection is due to their belief that they will not benefit from an EMR then that is a valid concern and far more than those resistant to change or fearing computers will be on that list.

    Bottom line if there are benefits that the PCP will see in clinical outcomes and practice business then docs will adapt and adopt an EMR.

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