The Absurdity of “Meaningful Use” Requirements in Dentistry

Let’s End the Silence

By D. Kellus Pruitt DDS

Hey, Doc. How can your silence possibly serve your patients’ best interests?

For my colleagues in the audience who have quietly examined the critical and timely issues I’ve repeatedly offered for discussion – adults with post-graduate degrees who might have briefly considered publicly responding  to what I write, but who still cannot take ownership of an opinion – what on Earth is holding you back? Whatever it is, I say there are only lame, self-serving excuses for dentists to continue to betray patients’ trust. So how does that make you feel, Doc? A little angry maybe? Indignant? Let’s work on that professional nerve a little more. Maybe I’ll get a rise out of you yet.

Where Have You Been? 

As a healthcare provider whose trusting patients depend on you to protect their interests from stakeholders who cannot be held accountable – where have you been? Do you really believe dentists’ stoicism upholds and promotes the ideals of the healing profession? What about the Hippocratic Oath? How?

Or, is your shyness perhaps the manifestation of a character weakness revealing little confidence in your own personal ethics? You can’t blame me if that pisses you off. As long as you are silent, it’s impossible for me to tell a thing about you. So please, feel free to describe how my observations make you feel. You could easily change my opinion by merely speaking up to defend your silence … which promises to be an interesting argument.

ADA Members 

Or, maybe, as an ADA member, or more so a vetted official, professional silliness isn’t your choice at all. Perhaps you are torn between supporting common sense and honesty in your community and a professional dedication to the ADA’s committee-approved slogan “Speaking with one voice.” What looks to me like a cheap PR hack’s piece of art – purchased by either a clueless or nasty-cynical ADA official – is intended to not only keep members in their place as policy, but to also give state and national politicians the impression that all dentists unquestioningly unite behind any and all ADA ideas – sight unseen. (Public discussion of policy with membership is never permitted, even though it’s just dentistry). Elsewhere in the world, that would be called tyranny. It’s also easy to see that “one voice” is a generous exaggeration of our current dental leaders’ influence in Washington.

Stage 2 Meaningful Use

If anonymous leaders who secretly manage a silent profession insulated from the community were the least bit effective at protecting dental patients’ welfare, dentists who actually provide dentistry for the poor wouldn’t be faced with absurd and overwhelming Stage 2 Meaningful Use documentation requirements that will be enforced by CMS in 2012:

  • Record Smoking Status for Patients 13 Years Old or Older
  • Generate Lists of Patients by Specific Condition
  • Check Insurance Eligibility Electronically from Public and Private Payers
  • Submit Claims Electronically to Public and Private Payers
  • Provide Patients with Timely Electronic Access to their Patient Information
  • Computerized provider order entry (CPOE)
  • eRX
  • Record Demographics
  • Record and Chart Vital Sign
  • Patient Reminder
  • Electronic Copies
  • Clinical Summaries
  • Advising Smokers to Quit

Rising Above Politics

As healthcare professionals, our patients depend on us to rise above political correctness and petty, cheap slogans. Indeed, how good is it for healthcare when doctors evade unpopular issues? Can anyone in the audience explain how our patients are better served by PR hacks than dialogue? Anyone?

Assessment

Face it. The absurdity of Meaningful Use [MU] requirements in dentistry proves that our non-responsive leadership is incapable of protecting our dental patients. From now on, only you and I can do that on our own as individuals. But to make a difference, you must be heard.

Conclusion

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6 Responses

  1. Prospects For Meaningful Use-Stage 2 Progress Questioned

    Click to access pcast-health-it-report.pdf

    Mary

    Like

  2. CHIME and MU Stage 1

    The College of Healthcare Information Management Executives (CHIME) is recommending that 30% of eligible hospitals (EHs) and eligible professionals (EPs) achieve Stage 1 meaningful use objectives before the Office of the National Coordinator for Health Information Technology (ONC) moves on to the more difficult Stage 2 Meaningful Use guidelines [mentioned above].

    http://www.informationweek.com/news/healthcare/EMR/229401964

    What a mess!

    Mary

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  3. Here’s how Meaningful Use of EHRs in dentistry slams hard against reality:

    If a dental patient has diabetes, before the dentist can leave the page to see which filling has to be replaced, he or she will be required to acknowledge the diabetes … again and again … by checking a drop-down box every time a patient with diabetes is seated.

    I bet that swell idea from academia will save a lot of lives – making EDRs well worth the cost of HIPAA compliancy. Don’t you?

    Since stakeholders are out of fresh ideas, EDRs are now being pushed as reminder machines so dentists won’t have to spend time memorizing stuff about how to treat compromised dental patients. HHS feels certain that clicking on drop-down boxes will relieve dentists of the need to think too hard about things. That’s worth something. Isn’t it?

    D. Kellus Pruitt DDS

    Like

  4. Stimulus money is no bargain

    “OIG Issues EHR Fraud Survey” by Scott Mace was posted today on HealthLeadersMedia.

    http://www.healthleadersmedia.com/content/TEC-285665/OIG-Issues-EHR-Fraud-Survey##

    “Attention, hospitals that have attained meaningful use status: The U.S. government may be asking you some tough questions as part of its oversight mandate, and you will have to answer quickly. Providers have until Friday, October 26, to respond to an 18-page, 54-question survey probing their electronic health record system data entry habits, security practices, and more.”

    Mace adds: “Recent reports in the New York Times concluded that some providers have used EHRs to inflate Medicare charges. Those reports prompted letters calling for investigation of the Meaningful Use program by Republicans in both the House and the Senate.”

    Now doesn’t that make you happy you didn’t accept ARRA stimulus money, Doc?

    Darrell

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  5. Docs Rejecting MU?

    Meaningful Use is no more meaningful than Affordable Care is affordable.

    If physicians are rejecting Meaningful Use requirements, how well are the non-productive, mandated tasks being welcomed by dentists whose practices are at least 30% Medicaid? It’s hard to tell. For one thing, the few HIT stakeholders who agreed to promote MU in dentistry aren’t saying much publicly.

    “Meaningful Use Has Larger Issues than Certification,” by Greg Slabodkin for HealthData Management was posted this morning.

    http://www.healthdatamanagement.com/news/Meaningful-Use-Has-Larger-Issues-than-Certification-48043-1.html

    According to Slabodkin, many in healthcare are “fed up with the number and pace of meaningful use requirements.” During a May 7 meeting of the national HIT Policy Committee workgroup, Mari Savickis, the AMA’s assistant director for federal affairs, said: “We fear that unless we change the course we are headed that we’re going to create a parallel market–the one where providers participate in meaningful use with certified systems and those who peel off and seek higher performing systems.”

    Do dentists want software designed according to the interests of dentists and patients – the principals in dentalcare, or according to the interests of stakeholders – everyone else?

    So how about Meaningful Use in dentistry? Principals should demand responses from otherwise unaccountable stakeholders who selfishly push dentists to purchase “certified” EDRs: The U. S. Department of HHS, the American Dental Association’s Department of Dental Informatics (DDI), and EDR consultant Michael Uretz, founder of DentalSoftwareAdvisor.com and “a nationally-recognized Dental software and Electronic Health Records (EHR) expert.” (from his bio).

    http://www.dentalsoftwareadvisor.com/mike-uretz-executive-director/

    As far as I know, nobody else in the nation is saying a word about Meaningful Use in dentistry. And for good reason. Imagine silliness.

    Several years ago, the ADA’s DDI proved its loyalty to silly HHS goals over dental patients’ interests by joining with insurers to persuade uninformed member dentists to quickly volunteer for their permanent HIPAA National Provider Identifiers – even members who do not transmit patients’ ePHI. At the time, both the head of the DDI and her superior, ADA Senior Vice President Dr. John R. Luther (who has since left the ADA for UnitedHealth), refused to acknowledge that the NPI’s true purpose has always been as an identifier for Pay-for-Performance internet report cards for dentists. P4P, President George W. Bush’s 2004 executive order to be carried out by HHS, rewards power and profit to the unresponsive ADA and others as enforcers of national “quality” control. Apparently, the ADA lied to us about the NPI to protect conflict of interest, Doc.

    As far as I can tell, Mr. Uretz is the only dental practice consultant in the nation promoting Meaningful Use – even for dentists who don’t accept Medicaid. (See: “Getting the Meaningful Use Incentive through Clinically Useful Dental Software,” by Michael Uretz, Dental Software Advisor, undated).

    http://www.dentalsoftwareadvisor.com/getting-the-meaningful-use-incentive-through-clinically-useful-dental-software/

    Though patriotism may be a part of his motivation, I suspect Mr. Uretz has signed a promotional contract with HHS through the NY public relations firm Ketchum Inc… which was no stranger to federal charges of propaganda when HHS Secretary Kathleen Sebelius hired the firm. (See: “HHS Contracts With PR Firm Responsible For ‘Propaganda’ Videos During The Bush Administration,” by Matt Corley, ThinkProgress, March 30, 2010).

    http://thinkprogress.org/politics/2010/03/30/89396/hhs-ketchum-contract/

    Even before Mr. Uretz blocked me from commenting in his blog a few years ago, he never responded to my requests for a description of the requirements, and how each will improve the health of dental patients without raising the cost of dentistry. But then, Uretz is no fool.

    D. Kellus Pruitt DDS

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  6. ADA abandons Meaningful Use?

    Months ago, federal “Meaningful Use” subsidies to help dentists purchase tightly-regulated electronic dental records were still being promoted by unresponsive, anonymous leaders of the American Dental Association.

    Now, not so much.

    “A new study casts doubt on whether the billions of dollars spent so far in meeting meaningful use requirements is actually improving patient outcomes.” (See: “Why achieving EHR meaningful use is not enough to improve quality,” by Jeffrey Bendix, for Medical Economics, June 10, 2014).

    http://medicaleconomics.modernmedicine.com/medical-economics/news/why-achieving-ehr-meaningful-use-not-enough-improve-quality

    Other than the profound silence from the ADA about HHS’ dentistry plans which has lasted an unusually long time even for secretive ADA leadership – how can dentists tell what the ADA currently recommends concerning MU requirements?

    It looks to me like the Department of Dental Informatics, the ADA’s direct beneficiary of ARRA stimulus money, stopped pushing members to “meaningfully” use certified electronic dental records over a year ago. How time flies! I imagine the quiet, inevitable abandonment of HHS’ doomed idea occurred when government-friendly ADA officials realized the embarrassment in store for whomever tries to convince adults with post-graduate degrees that the MU requirements are anything more than silly, non-productive busywork.

    D. Kellus Pruitt DDS

    Like

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