Meaningful Use Is Dead?

Over on EMR and HIPAA, I got the following passionate response on my post titled Meaningful Use Created A Big Need for Certified MAs that I thought many readers on this site would enjoy.

In the EP world, MU is dead. There are some larger groups, especially primary care still struggling to overcome the huge hurdles of MU2, but most I know have given up and running for the hills. There is a ginormous gap between what ONC is peddling in terms of numbers and real MU use.

This is good example of another hidden cost of trying to MU. We have some excellent MA’s, and I could not tell you which are and are not certified. Makes no difference. Sadly, CMS and ONC, do not realize that they are literally driving EPs from accepting Medicare patients, especially us specialists. And once we are gone, or severely limit new patients with Medicare, we are not coming back.

So the 17 times in 11 years fix for SGR, PQRS, VBM, MU, CPQ, ICD10, HIPAA, RAC audits, sequester cuts, etc. Its too much cost. clicking, paper work to take care of these patients. We actually had a serious discussion with our hospital about cutting back severely on doing Medicare total knees and hips next year due to all this. And the hospital initiated the conversation. So its not just us, even EHs are looking into this.

We all know that CMS and ONC want something, anything in terms of numbers to report anything to Congress, but this is the wrong way to do it. Again, everyone out there that is sitting in their cubicle Monday morning quarterbacking our care for these patients, will be very sad, very soon as we will just stop seeing them.

You can see by the numbers, if 250,000 EPs are taking the first MU hit this year, just wait until the rest give up. EPs can see that MU does not equate to better care, safer care, or more efficient care. We all may use an EHR, but could care less about attestations and audit risks and counting numerators/denominators forever. Again now that at least half the EPS are out, the rest will be right behind.

CMS and ONC need to realize that penalties NEVER work. Incentives like the heady days of MU1, got people to try EHR, but the costs are now piling up, big time. Everyone wants their piece of the pie. But as the incentives have gone away and the clerk like data entry has gone up, EPs have left the program. And are never, I mean never, coming back.

This provider makes an interesting assertion about meaningful use being dead. Do you think that MU is dead?

I thought this post’s timing was interesting given the announcement that CMS is changing the meaningful use stage 2 reporting period to 90 days. Correction…they intend to change it, but I think we all see that it’s going to happen. Just let the rule making process take it’s course.

Before this announcement, I would have largely agreed that meaningful use was pretty close to dead. I know some people have sifted through the meaningful use stage 2 attestations and have said it’s better than we thought, but I think those are the early birds and not the majority. With this announcement, I think the majority will take a much deeper look at taking on MU stage 2. If CMS can simplify some things, I could see many participating to get the incentive money, but to also avoid the penalties. Penalties aren’t the end all be all for doctors, but they represent a big chunk of money for many doctors.

I’d love to hear your thoughts. What are you seeing in the trenches?

About the author

John Lynn

John Lynn

John Lynn is the Founder of 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.

5 Comments

  • “Meaningful” use is going to die. Unfortunately a prolonged and painful series of death throes will be required before we get rid of this horrendous, destructive program.

    You would be hard-pressed to find practicing physicians who think that spending 30 to 40 Billion dollars of your grandchildren’s money on “meaningful” use has been a good idea. However, you will find huge numbers of administrators who have tied their reputations and perhaps their jobs to installing electronic health record systems at a price of tens to hundreds of millions of dollars per hospital. These EHRs have resulted in decreased productivity, decreased efficiency, decreased physician satisfaction and increased cost, all without improving the quality of patient care.

    What this means is that the larger the institution, and the more layers of bureaucracy that exist between the practicing physician and the administration, the more likely “meaningful” use will be supported and continued. In smaller hospitals or in physician practices where there is no insulation of the administration from the practicing physician, meaningful use will die more quickly.

    Unfortunately, the large centers, with huge amounts of bureaucracy insulating administration from their physicians, also happen to be the major academic medical centers which both monopolize the medical literature and monopolize consultations to the federal government. As such, administrators, sub-administrators, and sub sub administrators who have tied their jobs and perhaps their academic careers to the success of “meaningful” use will “spin” in the literature and “spin” to the government that “meaningful” use is a wonderful and successful program citing the successes, both real and imagined.

    Unfortunately, the number of EHR’s installed is being used as a surrogate for success rather than the successful implementation of EHRs to improve quality of care. When you count EHR installations, “meaningful” use looks like a success. However, when you count successful implementations of electronic health records that have improved quality of care and increased efficiency, it becomes more obvious that “meaningful” use has been a disaster.

    In summary, “meaningful” use is going to die. The only question is how many good physicians is going to take with it.

  • Kevin,
    I’ve written a few posts similar to that. If EHR adoption is the only measure, then MU has moved the needle. However, is that meaningful?

  • I’m gonna jump back in here. With little to no incentives left, and just penalties at this point, adoption should be the only criteria. This leaves a ton of room for creativity for workflow, safety, security and most of all usability. Once EPs get motivated on EHRs we are open to interop. But interop in the face of a dead MU program (I totally agree its dead), makes no sense. Make interop the one and only measure for the next stage. The rest is just data entry busy work. But we have to be in Denver smoking weed, if ONC and CMS will drop all measures. But truly, its the only thing that will work at this point. Because as you said, MU is dead.

  • John, I read you Blog regularly and I think we agree that MU had as its goal installing EHRs that were meaningful to use. Being unable to accomplish that goal, they have moved the goalposts and insisted that number of installations was all that was important, not number of useful EHRs. It was a way to call a failed program a success.

    I heard one of the ONC types say we needed a bunch of EHR installations now so we would be ready for CDS in the future. Unfortunately that is like saying we should make everyone buy a mini van today so we will be ready for high speed rail in a few years. Today’s EHRs have as much relationship to CDS as mini vans do to modern trains.

    Making interoperability the measure of success sounds like a better idea, but I hesitate to give the government any more power than it already has.

    With Meaningful Use dead, and the government out of the way, perhaps EHR vendors will start focusing on quality of care, efficiency, and usability. Perhaps then we will see useful EHRs that stop sapping the strength of our healthcare system.

  • Kevin,
    I think the issue was they needed to spend some stimulus money and they had a bill sitting there for $36 billion for EHR. Technology for healthcare? That sounds good. Should we have them certified so that doctors have the right features. Sounds reasonable. Should we make sure they’re actually using them? Meaningful use sounds reasonable. Alright, let’s add it to ARRA.

    I don’t think much more thought was put into it than that when it was included in the stimulus package. So, I’d say that no one in government had a specific goal with the stimulus. They just had a trillion dollars to spend and took whatever bills sounded reasonable. This sounded reasonable. I can’t imagine anyone in congress ever really looked into the actual details.

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