Meaningful Use: A Winding, Difficult Path
Farzad Mostashari, MD, the head of the Office of the National Coordinator for Health IT, recently announced at the National Health IT and Delivery System Transformation Summit in Washington D.C. that his office is busy reviewing information from the Health IT Policy Committee that will likely change the final meaningful use rules. The rule changes will undoubtedly have an impact on the way hospitals and providers implement medical software.
Growth and Change of Meaningful Use
Mostashari announced earlier in June his recommendation to delay Stage 2 of the meaningful use program to 2014 for providers complying with Stage 1 in 2011. Meaningful use’s current aims are to leverage certified electronic medical record software to improve the quality, safety, and effectiveness of patient care.
Mostashari commented that the final rules and the policy committee recommendations “will not be identical… [but] a lot of deference will be given to the committee.” Mostashari further commented that meaningful use is not a mishmash of bureaucracy, but “…the roadmap for delivering higher quality healthcare.” During the summit, he emphasized meaningful use as the way to reach improved patient care and a more holistic medical system.
Some of the medical IT growth indicators the ONC director used to support his meaningful use efforts were the growing adoption rate of electronic health records from 20% to 30%, 86% of hospital CIOs intending to apply for meaningful use, and 5-10,000 providers registering for meaningful use every month.
Dissonance and a Difficult Path
Some don’t agree with Mostashari’s interpretation of these statistics. Jeff Rowe, editor at HealthcareIT News, points it :
“…in looking at EHR adoption by hospitals, he noted that ‘a couple of years ago 10% of hospitals had a basic EHR system in place. Now surveys indicate that more than 86% of hospital CIOs intend to apply for meaningful use, with 60% expected to apply in the next couple of years.’
Again, “intend” and “expected” are verbs which perhaps one should avoid if one is trying to judge a program’s actual level of success.”
The ONC director noted that the plan for meaningful use is only a best guess. Yet he remained adamant about the need for action in reforming patient care. He remarked:
“We can do nothing or we can make our best guess at what is the right thing to do. Another option is to make your best guess but recognize that you are probably wrong and try to build in a way that’s sensible enough but not overly specific so it can move us forward and yet accommodate a variety of future scenarios.”
One of his cited examples was the health information exchange, a sort of unified network to allow medical information to flow easily between providers in order to optimize patient care, which needs to accommodate personal health and community health records in the future.
The healthcare system is huge, with health spending as 15.3% of the GDP. That’s the highest of any industrialized nation. The government is wise to tread carefully in changing the systems and processes of American medicine. A continual fact based monitor, analyze, and improve approach is the best way for reform to be carried out. There is no 100% confidence level for a proposed solution. There is only the plan and how it changes as it meets reality
What do you think about meaningful use? Has your organization applied for it? How should meaningful use and medical software be implemented? Leave your thoughts in the comments below.