Has Meaningful Use lost its utility for physicians?

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Now seems to be the time for physicians to evaluate their participation in the Meaningful Use program. After all, we're on the brink of leaving the carrot-only incentive phase and entering the penalty phase for those providers who don't meet federal requirements.

On the surface, the water appears fine. Electronic health record adoption rates are at their highest. A recent SK&A report determined that EHR use among physicians is up 10 percent from last year, and now at 61 percent overall. The Centers for Medicare & Medicaid Services also recently reported that the Meaningful Use program is making "exciting progress."

What's more, physicians are in favor of EHRs, in concept. According to a recent RAND Health report, the physicians surveyed found EHRs beneficial in providing them with remote access to records and in improving the quality of care provided. They also are "optimistic" about the future of EHRs.

However, according to that same RAND report, physicians remain unhappy with how EHRs work, despite the fact that we're already several years into the Meaningful Use program. The report reveals that the same problems that have always plagued the physicians still exist: poor usability; time consuming data entry that could be performed by clerks or scribes; unreliable data; interference with patient interaction; less fulfilling work content; and lack of effective data sharing.

Moreover, this is the year that the more stringent Stage 2 requirements kick in, and many physicians are being left stranded by vendors who have not yet upgraded their systems to the 2014 edition of certification, or have decided not to try. As Micky Tripathi, President and CEO of the Massachusetts health Collaborative, told me this week, he would not be surprised to see practices drop out of the program because they can't afford to buy a new EHR system. Even some physicians who don't have to switch likely will opt not to participate, he says, so they can concentrate on ICD-10, the Affordable Care Act and other initiatives which they deem more important.

We know that the Meaningful Use program is the big driver in EHR adoption. So why isn't the program making EHR use better and easier, either directly by regulation or indirectly by market forces?

Tripathi said that, in general, the program has been a "runaway success." But is it still helpful to physicians? Or has it lost its utility?

If a lot of physicians begin to drop out because it's no longer worth it to them, that's a significant issue. After all, the "payment adjustment" they'll ensure is much smaller than the one imposed on hospitals who fail to meet Meaningful Use. They have less incentive to participate.

Policy makers and others may consider taking a hard look at physician dissatisfaction with their EHRs and the Meaningful Use program and adjusting the program to address this dissatisfaction more aggressively. Otherwise the defections may snowball--and the fallout may not be pretty. - Marla (@MarlaHirsch @FierceHealthIT)

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