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Why the Meaningful Use criteria won’t increase provider adoption levels…

Ultimately we all expect that healthcare IT will improve the quality of care and lower costs.  I was *hoping* that the Meaningful Use (MU) criteria would help get us there by solving the biggest issue that we have today – low levels of provider adoption of EHR.   I was *hoping* that the MU criteria, combined with the financial incentives and future penalites, would make it a no brainer for non EHR providers to drop everything and install technology this year.  Here is why it won’t happen…

What has happened is that criteria have instead been created to justify the payments to providers that already use EHR.    I say, write these folks a check and congratulate them, they paid their dues and jumped on the EHR bandwagon early.  And instead, lets focus on the non-adopters.  What would it take to get all the non-adopters who:

  • are worried that their productivity will take a hit
  • know other providers who have failed and are scared
  • do not have the time to search for a system
  • cannot afford to implement and maintain a system
  • fill in your reason here…

off of the bench on into an EHR?  It certainly won’t be implementing a system to track immunizations – which sounds like a fairly simple criteria but in reality is very worlflow intensive.  Enter lot number, enter an expiration date, barcode scan if possible, make it easy enough that I can do this a hundred times per day in a pediatric or flu clinic.  Have the patient sign a release, get the data into the primary chart (if I don’t have a complete EHR this would mean printing into a paper chart or scanning) and into the billing system, send it to the state registry…  The process is just as complicated to utilize a system to track problem lists – is the problem chronic or acute? active or inactive? how does the system track problems across a multispecialty practice where each provider only wants to see their own problems?  and again, how would this feature function if part of an “EHR Lite” that had to integrate with other documentation workflows.

My point is that these seemingly simple items impact provider and staff productivity to a great degree.  Let’s make it easy for non-users to get into basic functionality like eRx, orders and results.  Affordable, web-based products with simple implementations that can actually be supported by a regional extension center and, more importantly, can add value to a providers office.  Make it easy for these folks to get into technology, show them how it can positively impact their day, then let’s worry about collecting meaningful data and adding complex functionality.

*Let the record show that I am a proponent of EHR’s and believe that anyone can obtain success in their EHR implementation if they have the right expectations, a lot of patience, an experienced implementation team, a solid scalable product, and a committed leadership team.

2 thoughts on “Why the Meaningful Use criteria won’t increase provider adoption levels…

  1. Marty Frygier Post author

    Many thanks for taking the time to comment EHR Guy. I know that a lot of smart folks are out there thinking about these issues and helping to shape the direction that our healthcare industry is taking. The more feedback we can share the better. Good day.

  2. The EHR Guy

    Nice post Marty!

    A big concern is: is the “stick” hard enough so that they prefer to eat the “carrot”? Or is it just one of those “pool noodles”?

    In the primary physician office space the $44K “carrot” may not be enough for the perils and headaches of implementing an EMR. Many physicians know this already, especially most of the ones who have attempted in the past to implement one.

    In the provider domain maybe the “incentive” appears to me more appealing due to the amount. But lets remember that many providers have consecutively failed to implement EHRs. The only thing they actually implement successfully is the IS infrastructure because billing and income are so dependant on it.

    The “Meaningful Use” bar, for the first stage, is being set so low that technology adoption complexities have been minimized. Albeit I realize that public comments will make the outcome different. I’ve made proposals which after public comment have helped to drastically change what was originally intended.

    I agree with the title of your post in that “Meaningful Use” is irrelevant to the implementation of EHRs. A pragmatic shift in the clinicians attitude toward technology would be of more help. So would technology being designed according to the clinicians workflow because we all know that a mouse, keyboard, and monitor get in the way of the clinicians routine.

    Two cents! I don’t want to make the reply larger than the post! :-)

    http://twitter.com/theEHRGuy

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