I concluded my last post (EMR – The Word on the Street – Part 3) on meaningful use and patient engagement. Although my first session had concluded with patient portals, I had a chance to revisit my group last weekend. Luckily, during the time since our last meeting most of the group members had managed to experience healthcare automation first hand. Our discussion had sparked an interest and increased their curiosity. One member even admitted visiting his primary care physician just to experience the new exam room dynamics. “I just called in and scheduled a physical. I knew they had converted to an EHR some time back.”
However it was pertinent to note that a few of them had learned about the government incentive plan and they were quite intrigued when I mentioned the meaningful use program and its objectives. The initial phase seemed to go well with the group. They unanimously agreed that it was a good idea to incentivise the adoption, while most of them agreed that setting EMR objectives should also benefit the healthcare sector. One member though keenly pointed out that such objectives could prove to be a distraction for the physician. “Wouldn’t this make the physician more concerned about his checklist?”
The recent feedback on meaningful use has been somewhat similar in this regard. Many professionals are now questioning ‘the carrot approach’ to meaningful use. Some even going as far as to regard it as unethical. However, personally I believe that meaningful use serves a purpose in its own right. The program has brought a method to medicine. While standardization may not be good for free flowing innovation, meaningful use has brought a purpose and direction for electronic medical records today. Without it, I doubt we would have seen this much progress in terms of interoperability and health information exchange. I also feel obliged to point out that the meaningful use program is completely voluntary, and physicians who feel as though such measures may affect their care delivery process are free to operate without them.
The meaningful use objectives though are likely to become more challenging with time. With the final rule for stage 2 out now, ONC has made its intentions clear. EMR vendors may have been given a lifeline this time around with some relaxation in interoperability requirements but ONC has made it clear where healthcare is headed. Electronic medical records would need to evolve with the requirements as stage 3 is unlikely to be as forgiving. Stage 2 sets up the practice for health information exchange while increasing its responsibility towards population health management. The group seemed to share a similar opinion on population health management and I think the following quote from a participant sums it up quite well, “Sure, I mean I can see how it would help in disease management, hospitals will be able to respond quickly and there would be a shift towards preventive medicine, but then again I have seen too many movies to know how this could all go wrong, very wrong.”