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Confusion About “Meaningful Use” Reigns

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Are Doctors Embracing or Ignoring ARRA?

By D. Kellus Pruitt DDS

pruittAre physicians embracing ARRA Meaningful Use cash incentives or ignoring them? That depends on whom one asks.

Doctors versus the Feds

National progress towards Meaningful Use of expensive EHRs depends on whether one talks to federal employees whose jobs depend on the stimulus mandate, or doctors who purchase EHRs to improve care rather than to use them … Meaningfully.

The Feds

Today, Joseph Conn, writing for ModernHealthcare, posted a rosy outlook for MU adoption according to researchers working for HHS’ Office of the National Coordinator (ONC). They base their optimism for job security on a recent National Center for Health Statistics (NCHS) survey:

“A growing number of office-based physicians are using more-robust EHRs that have higher-level functions needed to help the doctors qualify for federal EHR incentive payments [for Meaningful Use] and assist them in providing better, safer care for patients, the researchers reported.” (See “Researchers: More doctors using more-sophisticated EHRs”).


eMR and HIT Security

The Doctors

However, yesterday, in an InformationWeek article by Ken Terry titled, “Meaningful Use Doesn’t Drive Doctors’ EHR Selection,” doctors suggested a more depressing future for MU sophistication based on the same NCHS survey:

“Jason Mitchell, MD, assistant director of the Center for Health IT at the American Academy of Family Physicians (AAFP), told InformationWeek Healthcare that he found [the lagging adoption of MU-capable EHRs] puzzling. While there’s no doubt that Meaningful Use has driven much of the increase in EHR use, he said, it seems strange that so many physicians would buy and implement EHRs that could not be used to show Meaningful Use.”



Whom should doctors believe – HHS employees who give away billions of stimulus dollars for Meaningful Use, or family physicians who have determined that the subsidy isn’t worth the cost and effort?


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11 Responses

  1. Doc Groups Want Delay in Meaningful Use

    Darrell – Some leading medical groups have called on the Department of Health and Human Services (HHS) to delay implementation for Stage 3 of meaningful use for electronic health records (EHRs), saying providers are still trying to implement Stages 1 and 2.

    In its comments on proposed Stage 3 requirements issued by HHS, the American Academy of Family Physicians (AAFP) called for a delay in implementation until at least 2017, adding it also wants to delay or eliminate penalties for the third and final stage of the EHR incentive program.

    Any other thoughts?

    Dr. David Edward Marcinko MBNA


  2. Since the ARRA Meaningful Use requirements drive EHR design rather than innovative, free market competition to satisfy customers’ needs, if I were asked when the HIT bubble burst, I would point to October 4, 2012, when four Republican Representatives simply blew too damn hard.

    That is the date on the letter sent to HHS Secretary Kathleen Sebelius, signed by Representatives Dave Camp (R-Mich.), Fred Upton (R-Mich.), Wally Herger (R-Calif.) and Joe Pitts (R-Pa).


    After suggesting that the Secretary’s EHR incentive program “appears to be doing more harm than good,” they urged her to rethink her strategy: “Continuing down the current path will further exacerbate Medicare’s looming bankruptcy, create demand for billions of dollars in additional incentive payments once interoperability standards are finally put in place and further frustrate providers.”

    Unfortunately, the Representatives’ solution is to “Significantly increase what’s expected of Meaningful Users.”

    This reminds me of a scene in the 1980 spoof of disaster movies “Airplane!” After an attendant fails to gently calm a panicking, hysterical woman, other passengers’ increasingly aggressive efforts for cooperation are equally unsuccessful. As the camera pans down the aisle of the aircraft, a long line of stakeholders appears – all eager to help. Some bringing their favorite tools.



  3. Wishy-washy lawmakers

    Oh, those silly wishy-washy politicians!

    “Bill Aims To Offer Exemptions From Meaningful Use Penalties”


    Imagine a physician with a small practice who too quickly purchased an expensive and dangerous certified EHR system in order to attest to time-consuming and meaningless Meaningful Use requirements – just to avoid Medicare’s threatened 5% penalties.

    Now, imagine the anger when the federal government says, “Never mind.”

    D. Kellus Pruitt DDS


  4. I salute you, Dr. Marcinko

    Today, the Medical Executive-Post picked up “Wishy-washy lawmakers” as well. That makes three articles in one day – tying my personal record.



    I don’t mention it nearly enough that I am forever thankful to Dr. David Marcinko and his ME-P staff for their generosity with me – even while 3rd parties in dentistry hide dentists’ concerns about the future of the profession, as well as the welfare of dental patients.

    It has become clear to me that even in a nation which prides itself on freedom of speech, publishing politically incorrect information is risky.

    Dr. Marcinko has proven to me that he is a courageous man.

    Darrell Pruitt DDS


  5. Darrell

    Maybe it’s because Easter/Passover is a slow news weekend.



  6. GOP Senator calls for MU pause

    Trying to soften the sting of his remarks by iterating that he does not want to see progress stalled on health IT adoption, Utah Sen. Orrin Hatch explained that the federal government cannot afford to spend money on programs that are not working.




  7. CMS extends meaningful use Stage 2 and 3

    The extra time is most welcome among small and mid-size physician practices already struggling with the meaningful use program’s fast pace.


    Ann Miller RN MHA


  8. Why the MU extension is failing physicians

    We have written and opined on this topic before. The front-end loaded subsidies, and onerous back-end load MU requirements, are not worth the effort and ROI for average doctors.


    EMRs are not worth the investment for most providers, this new research suggests, and elongating the stages won’t make that any more tenable.

    Hope Rachel Hetico RN MHA
    Dr. David Edward Marcinko MBA


  9. CMS Proposes Stretching Stage 1 in EHR Incentive Program

    Darrell – Healthcare providers will have one extra year to use 2011 Edition software in their electronic health record systems under the federal incentive program for health IT under a proposed rule the CMS issued Tuesday. Providers scheduled to jump to the program’s Stage 2 criteria will have another year to stay at Stage 1.

    Hospitals, physicians, and other eligible professionals trying to meet the program’s Stage 1 meaningful-use criteria can continue to use 2011 Edition software under the proposal, which will give them “more flexibility,” according to a joint announcement by the CMS and the Office of the National Coordinator for Health Information Technology. The agencies cited the slow delivery and implementation of the upgraded 2014 Edition software as the reason for the delay.

    Source: Joseph Conn, Modern Healthcare [5/20/14]


  10. I think HHS Secretary Sebelius picked a good time to give up

    “’Doctors aren’t robots and can’t enter 5 million things [into an electronic health record] during a visit and still focus on the patient,’ said Margot Savoy, M.D., medical director of family medicine centers for Christiana Care Health System.

    ‘Patients tell us that we spend a lot of time with our faces in computers and not a lot of time listening to them and hearing what they have to say.’” She adds, “if you all of a sudden have to hire a scribe or a nurse to make sure the data gets in the right spot, all of those savings just get lost in another salary and another person having to be there to make it happen.”

    –From “Providers Ask ONC to ‘Pause’ Meaningful Use,” by Greg Slabodkin, HealthData Management, May21, 2014.


    Darrell DK


  11. CMS Relaxes Provisions of Meaningful Use Programs for 2018

    The Centers for Medicare and Medicaid Services has acted to substantially reduce burdens on hospitals aiming to achieve the meaningful use of electronic health records. Hospitals will be required to report only four electronic clinical quality measures (eCQMs) in 2017 and 2018, instead of eight measures. And, providers can select any quarter of data for eCQM reporting for both years.

    Also under the final rule, CMS is establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

    Source: Joseph Goedert, Health Data Management [8/3/17]


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