February 11, 2014

2014 Predictions - Meaningful Use Continues to Challenge IT Departments

Travis Good, MD
Travis Good, MD

Datica Alumni — Former Co-founder & Chief Technology Officer

Meaningful Use has been one of the biggest topics in the health IT industry for the last several years. Meaningful Use (MU) was introduced in 2009 as a part of the HITECH Act. Basically it’s an incentive program that was created to encourage providers, physicians and health systems, to adopt electronic health records (EHRs). EHRs need to be certified for providers to get the financial incentive that goes along with MU. If a provider can show that he/she is using a certified EHR, that provider is eligible for financial incentives from Medicare or Medicaid of $44K or $66K, respectively. Those payments are spread over 5 or 6 years.

The reason behind the program is to create financial incentives for using an EHR. Why is that needed? Good question. I had always assumed you wouldn’t have to push so hard if the EHR systems were beneficial or had a clear ROI. The reasons given for MU are typically that EHRs lay the foundation for the changes that are needed to deliver on the triple aim of health reform - lower costs, better outcomes, happier patients (that are ideally more engaged). Much of this perceived value relates to interoperability, analytics, decision support, and quality tracking. The evidence that EHRs, at least the current crop of dominant EHRs, can help with any of the 3 aspects of the triple aim is scant at best. The utility and value of EHRs in healthcare is a topic for another post, or any entire book for that matter, but there are arguments on the other side that simply adopting and not optimizing is the major problem with current EHR installs.

The reason MU will continue to be a major trend in 2014 is that MU Stage 2 kicks in this year. MU is broken into 3 stages. The first stage, which set a very low bar, ran through 2011 and 2012. Stage 1 focused on data capture. Stage 2 raises the bar considerably, and there are rumblings in industry circles that Stage 2 will not be a smashing success. Stage 2 has a focus on quality and reporting, as well as more interoperability. Recent data shows that 56% of providers intend to participate in MU stage 2 but are not ready; only 13% intend to participate and are ready.

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That’s scary, especially considering 2014 is also the year that providers have to be compliant with ICD-10; October 1st, 2014 is the exact date for ICD-10.

Through the end of 2013, CMS had paid out $19 billion in EHR incentives, showing the size of the MU program. With EHRs representing the largest software costs for almost every healthcare organization, and those organizations having invested heavily with plans to get incentive payments, there is a lot of pressure on hospital IT, and by extension EHR vendors, to meet MU. With the amount of resources - financial, human, and organizational - required to meet MU, our hope is that there is a real benefit at the end of the road for the healthcare systems, providers, and, most of all, patients.

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