Whenever I mention the words “meaningful use” to someone in the healthcare industry, I am usually met with a sigh and an eyeroll. And that’s if they’re being nice.
Meaningful use is getting a bad rap these days, with many sharing the sentiment that meaningful use seems, well… less than meaningful.
Fact is, meaningful use is hard – probably harder than many providers thought it would be. In fact, new statistics from the Centers for Disease Control and Prevention estimate that only 18% of doctors may be eligible for meaningful use incentives¹, while John Halamka, CIO of Beth Israel Deaconess Hospital in Boston (and someone who is outspoken on many health IT issues), estimates that 80% of hospitals will fail to attest to meaningful use Stage 2 on time².
Meaningful use started with such promise when the Centers for Medicare and Medicaid Services (CMS) created incentive programs so that hospitals could improve patient care and outcomes through the “meaningful use” of electronic data from certified EHR systems. As of October 2013, 85% of eligible hospitals and more than 60% of eligible professionals had received a Medicare or Medicaid EHR incentive payment through the program for Stage 1. So what went wrong?
In a nutshell, CMS staged the program so that in Stage 1, hospitals and doctors just had to have systems in place and prove that they could do what was being asked of them. Now that we’re into Stage 2, providers must input the data and validate that they are getting everything. And that’s the difficult part.
One of the big challenges with meaningful use – now that we’re at the “proof” part of the incentive program – is that it requires process flow changes. And as we all know, people don’t like change. Try to tell a doctor or a nurse (or anyone for that matter) how to do their job, and they will rebel – especially if they perceive the new way as harder or as more time-consuming than the way they’re already doing it. When you have patient after patient to see – even worse if you’re trying to triage them in the emergency room! – it is not going to be easy to convince busy clinicians to change their processes when it takes a lot more time and they don’t understand why they’re changing in the first place.
As a result, many healthcare staff are creating work-arounds to bypass the system. For example, they might put any letter or symbol into a “required” field just so that they are able to get to the next step. Obviously, this provides no added value to the ability to capture “meaningful data” in order to measure outcomes. This is when meaningful use really provides little meaning – when there is such a disconnect between the technology that’s being implemented and the staff who have to work with it every day. If the technology is not being used to do what it is supposed to do, then what is the point?
So where do we go from here? How do we change the way that people work without forcefully ramming change down their throats? In my next blog post, I’ll talk about how we can again find the meaning in meaningful use.
Read our blog series on meaningful use:
Is Meaningful Use Less Than Meaningful?
How to Find the Meaning in Meaningful Use
- 3 Ways Hospitals Will Benefit from Getting Meaningful Use Right
¹ “Trends in Electronic Health Record System Use Among Office-based Physicians: United States, 2007-2012,” Centers for Disease Control, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, May 20, 2014.
² “Dr. Halamka’s Dramatic MU Prediction in Boston,” Healthcare Informatics, May 13, 2014.
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