Meaningful Use about better care, not just better technology

About a quarter of hospitals are qualified to meet the Stage 1 Meaningful Use criteria, according to a recent CHIME survey. Many institutions are still finding it difficult to implement the necessary software and reengineer their operations to meet requirements in such areas as computerized physician order entry, quality reporting, and health information exchange.

It's likely that the Centers for Medicare & Medicaid Services (CMS) will push back the starting data for Stage 2 of Meaningful Use from fiscal 2013 to 2014. Yet there already is talk that Stage 2 may be pointless, because few hospitals will be able to achieve the government's goals.

This conversation is taking place inside a bubble. The larger goal of Meaningful Use is to equip providers with the information technology they will need to achieve the "triple aim" of the Institute for Healthcare Improvement: reduce the cost of care, improve population health and enhance the patient experience. If healthcare organizations can't achieve these goals, it won't make any difference whether they attain Meaningful Use, Stage 1, 2 or 3.

Some recent discussions with insurance company executives clarified my thinking on this subject. The insurers realize that they have a window of opportunity--in my opinion, no more than five to 10 years--in which to bend the cost curve. They want to collaborate with providers to accomplish that. If they can't do it, the government will be forced to take over healthcare, if only to prevent its own bankruptcy.

So the private health plans are surging ahead of Medicare in trying to help providers make the transition to the accountable care of the future. They're offering claims data, analytic capabilities, predictive modeling and alerts on care gaps to aid those organizations that are ready to make the leap to accountable care organizations. And, whether ACOs work or not, the insurers are plainly determined to do whatever it takes to find a model that will deliver quality care at a lower cost.

Some providers are working with insurers and/or Medicare to learn how to manage care and handle financial risk. Not all of these organizations have fully implemented electronic health records across their hospitals and clinics. But they and their physicians are already moving down the road toward coordinated care, knowing they'll soon have the health IT tools they need to make a successful transition to population health management.

Other providers, however, are not thinking beyond Meaningful Use. A recent CapSite survey demonstrated this point: While 48 percent of hospital respondents said they were involved in or wanted to participate in a health information exchange because of Meaningful Use, only 2 percent said they wanted to do it to prepare for ACOs.

As daunting as Meaningful Use may seem today, achieving it is not sufficient to meet the challenges of the future. Even if your organization has no plans to form or join an ACO, you should have a strategy for attaining the IHI's triple aim goals. Health IT is a facilitator, not an end in itself. Information technology will allow you to access records, automate care management and exchange information across care settings. What it won't do is get your physicians to change how they practice, or change the mindset of hospitals that think only about filling beds. - Ken

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