WASHINGTON—As the year winds to a close, several healthcare organizations announced funding from the federal government for obtaining ‘meaningful use’ standardization of EHRs (electronic health records).
Late in December 2011, providers from Rockford Orthopedic, in Rockford Ill., announced that they received a $378,000 check from the Centers of Medicare & Medicaid Services (CMS), the maximum amount allowed for 2011. Hoboken University Medical Center met CMS’ Stage One Meaningful Use requirements and is receiving an initial reimbursement from the federal government for the implementation of Medsphere’s OpenVista EHR enabling system. The New Jersey hospital will receive an estimated $8 million overall in federal stimulus funds, $3 million of that this year.
The Medicare and Medicaid EHR Incentive Program provides a financial incentive for the “meaningful use” of certified EHR technology, with the objective of achieving health and efficiency goals. The idea is that by putting into an EHR system in place—and actually using it in a meaningful way—providers will reap benefits beyond financial incentives. Benefits are expected across a spectrum, from a reduction in errors and availability of records and data to clinical decision support and e-prescribing and refill automation, according to CMS.gov.
The American Reinvestment and Recovery Act (ARRA) established these incentives to reward medical providers who successfully demonstrate meaningful use of an HER system in ways that improve the quality, safety and effectiveness of patient-centered care.
It turns out that CMS has handed out close to $1 billion to providers through November 2011 and $2 billion overall, according to CMS. More than 10,000 eligible professionals have received $920.3 million Medicare Meaningful Use incentive dollars. Medicaid has pitched in more than $916 million to more than 11,000 providers.
The first payments for meaningful use went out in May 2010.
As funds continue to pour out to the nation’s healthcare practitioners, there’s at least one question that will continue to arise: Does Meaningful Use work?
Dr. Margaret Polaneczky, a board certified obstetrician-gynecologist and Associate Professor of Clinical Obstetrics and Gynecology at Weill Medical College of Cornell University in New York City, posed the same question in her blog post, The Meaningful Use Song (with Apologies to Gilbert & Sullivan), asked the same question.
Here are Dr. Polaneczky’s thoughts on the matter, posted October 28, 2011:
"Does Meaningful Use Improve Clinical Outcomes?
That’s the 20 billion dollar (the amount 2009 Hi-Tech Act allocated to the meaningful use incentive program) question. We really don’t know as yet whether or not EMR use itself favorably impacts patient care. Some studies say EMR use does not improve health outcomes, but more recent studies of diabetes care and in low resource areas have suggested that EMR use may be beneficial.
We also have no idea if docs who attain meaningful use are better docs than those who don’t. Despite this, the CMS website will have clear implications as to the outcomes of doctor’s practices in terms of standard quality measures. It’s a bit worrisome to me, especially since so many of the outcomes are driven by patient compliance (a word I know a lot of my readers don’t like, but there it is…) Not to mention the thorny issue of using mammogram screening in women over 40 as an outcome measure when we just decided that it is no longer recommended to routinely perform it in everyone. (Don’t get me started on that issue again…)
Overall, I think meaningful use is a step in the right direction
I do see meaningful use as an attempt to rein in the wild, wild west of EMR development to try to create some standardized functionality and communication. It’s also a way to begin to corral the freestyle and autonomous EMR use that has evolved among early EMR users, who did what they needed to do to get their work done during the evolution of the EMR around them, but who now need to step back and reassess how well (or not) they are using this powerful tool that has been foisted upon them.
But my god, this whole process has been painful."
For a little humor on the subject, check out Dr. Polaneczky’s Meaningful Use song: http://www.tbtam.com/2011/10/meaningful-use-emr.html
And here’s another, The Meaningful Yoos Rap, by Dr. HITECH