Niam Yaraghi: Stage 2 of Meaningful Use has 'failed'

While there are many benefits of health IT, forcing providers to comply with Stage 2 of the Meaningful Use program has been a failure, according to Niam Yaraghi, a fellow at the Brooking Institution's Center for Technology Innovation.

In a recent blog post, Yaraghi says that Stage 1 of the program created an artificial market for electronic health record systems, and that providers were willing to buy the government-subsidized products without worrying about actually using them.

Now that Stage 2 has gone into effect, however, providers are required to use their EHRs; to that end, forcing physicians to adopt and use a one size fits all program was "destined to fail," he says. Instead, according to Yaraghi, adoption should have been allowed to be "organic and voluntary." Health IT, he adds, is a means to achieve the goal of efficiency and forcing an EHR as the only IT solution ignores the fact that other IT services likely would be better.

The Meaningful Use program has come under increased criticism as it progressed to Stage 2 and providers struggled to meet the additional burdens. CMS and ONC have proposed a rule to soften Stage 2's requirements but so far have not heeded calls to delay Stage 3 of the program.

Efficiency, Yaraghi says, should have been the program's primary goal from the get-go; how doctors reached their results should have been more open ended, he says.

"Instead of mandating physicians to record the smoking statuses and vital signs of all patients, send them reminders about their follow-up visits, and communicate with them through secure electronic messages, Meaningful Use incentives could have been allocated to fund a wide variety of different IT solutions suggested by medical providers," he says.

Yaraghi also believes that forging on to Stage 3 is a mistake:

"[B]efore implementing more complicated rules and regulations, we should have a clear understanding of the reasons for which the second stage of the program has failed," he warns. "Without learning from the past, the future will not be brighter."

He recommends that to save Meaningful Use, the incentive money should be used to test a pilot allowing providers to determine which IT solution is best for them to attain efficiencies.

To learn more:
- read the blog post

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