Meaningful Use impact on physician EHR adoption 'weak'

The Meaningful Use program and its incentive payments lack "statistical significance" on physicians' adoption rates of electronic health records, according to a study in the Journal of the American Medical Informatics Association (JAMIA).

The researchers, from the University of Alabama at Birmingham's School of Public Health and elsewhere, assessed the impact of the Meaningful Use program on EHR uptake by examining adoption by nonfederal office-based physicians, excluding radiologists, anesthesiologists and pathologists. They used a diffusion model of new products to examine the shape of the diffusion curve to plot sales or share of potential market.

They found "weak evidence" that the program impacted EHR rates; the external stimulus on physicians had "ambiguous" effects on adoption. Instead, adoption was largely driven by mimicking their peers' technology use or by responding to mandates.

The Meaningful Use program and the incentive payments "contributed statistically insignificant nudges to the EHR diffusion curve of less than one percentage point and a half percentage point, respectively," the authors said, noting that the adoption rates would have been as high just two years later, even without the program.

The study's authors likened the Meaningful Use program to the "cash for clunkers" subsidies in the car industry, in that the Meaningful Use payments may have only contributed to "inevitable" adoption of EHRs. In fact, the program may have had negative unintended consequences, such as stifling technological innovation in favor of meeting "certified" technology.

"Did forcing the adoption of EHRs save lives, improve the quality of care, or favorably reduce inflation in medical spending? Evaluations of the effects of EHRs to date have found weak and inconsistent effects," the researchers said. "Absent evidence of significant gains in either care quality or cost savings, the federal government's near-term return on investment may be negligible or negative. Additionally, little generalizable evidence currently exists to show that the electronic exchange of health information among providers boots efficiency, reduces healthcare costs and improves outcomes for patients."

The authors also recommended that future studies examine the impact of the HITECH Act on costs and quality outcomes.

The study provides additional evidence bolstering concern about the benefits of the Meaningful Use program and its continuation.

To learn more:
- read the abstract

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