Why MU alone won’t get us there…

For those of you that are familiar with the Electronic Health Record (EHR) world, you know about ARRA, HITECH and Meaningful Use. If so, you know that Meaningful Use is meant to give practitioners incentives to switch their charting to digital. And while Meaningful Use at it’s core has a very humanistic and futuristic spirit, it’s implementation via monetary incentives alone removes from some of it’s core purpose: increasing positive patient outcomes and decreasing cost. While Meaningful Use (MU) is and should be a clear principal player in the move toward modernizing health care, this concept alone is not enough to get us there. Here’s why:

  1. Each time you give people monetary incentives to perform some act, while there are clear short-term benefits (in our case rises in EHR usage), the push does not come from within. Providers today aren’t switching to digital systems because they truly believe in today’s technology (and to some extent…one can understand why). The switch is done to gain incentives and avoid Medicare/Medicaid penalties. Because of this, using an EHR becomes a chore.
  2. There is no organic growth. Every time we get new reports stating that $x bil were paid to providers, I cringe a little inside. Its great that practices now have some extra cash to invest (maybe hire an unemployed person)…but this growth is superficial and it’s made up. What happens when the money runs out….will we really get to a point where the majority of docs will be on a digital system? Only time will tell.
  3. There is a clear focus on practices, while patients are completely ignored. And by completely, I guess I should mention that HealthIT.gov does have some patient educational material that for some reason, no one knows exists (its here). Remember that core purpose….increasing positive patient outcomes and decreasing cost? To this day, the focus sits 100% in the hands of practices, with no control given to patients. Now I should state that at the time of this blog post, there are rumors of MU Stage 2 announcements creeping around, mentioning PHR and increasing PHR use among patients….I CAN’T WAIT FOR THAT!
  4. While most practices would agree that digitizing their charts is a good thing, there are still those practices that would rather retain full control of their charts (after all, the government doesn’t ask APPLE to provide info on their entire business practice). With Meaningful Use, there is still the sense that Big Brother will take over charts and tell docs what to do. Sadly, when Health and Human Services spending is the top dog in the FY 2012 budget, I can somewhat relate.

If we are ever to truly make an impact in our health care system, spending, patient outcomes and patient education/knowledge, we must take a multi-faceted approach, using Meaningful Use as a pillar or foundation. Meaningful Use should not be the keystone of the plan, nor should it be the only major player. For any movement to work and be impactful, we need organic growth adopted by physicians AND patients alike. Physicians must be ready to embrace patient education as second nature, patient records access as a necessity, and improved patient communication as the cornerstone to the success of their businesses.

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