The American Recovery and Reinvestment Act (ARRA) 2009 introduced the Health Information Technology for Economical and Clinical Health (HITECH) Act with the aim to incentivize “meaningful” implementation and usage of Electronic Health Records (EHRs) throughout the nation. Under HITECH, two incentive programs for Medicare and Medicaid were introduced which allow eligible professionals (EPs) to claim thousands of dollars in incentives over several years, provided that they are able to establish the requirements set out for different stages of Meaningful Use.
In essence, the rationale behind the requirements defined under the Meaningful Use criteria is to achieve maximum benefits of a wholly interoperable EHR system, so that a nationwide network of healthcare information is created. Such a network will not only ensure enhanced patient care but also result in patient engagement in the care delivery process which will considerably increase the quality of the national healthcare system and reduce overall costs.
Therefore, the benefits of Meaningful Use are far reaching with a long-term aim at changing the nature of the healthcare system. Effective implementation of Meaningful Use requirements will mean that providers have access to the information they need instantaneously, enabling them to swiftly diagnose problems and provide the best possible care.
As a result of its emphasis on interoperability, Meaningful Use ensures that information can be shared within a blink of an eye across healthcare providers, leading to better care coordination.
With patients being able to receive their clinical information electronically and securely over the internet, they will be in a position to be more proactive in their care management.
Naturally, immediate access to information on medications, allergies and treatment history will reduce the risk of medical errors to a large extent.
From a social perspective, all of these factors lead to healthier patient populations and communities. Electronic data capture and information sharing on diseases and outcomes means crucial information becomes available to other healthcare professionals not only in the US, but globally as well.
While these benefits are undeniable, final guidelines for Stage 2 of Meaningful Use issued by the Office of National Coordinator (ONC) and Center for Medicare and Medicaid Services (CMS) have caused some frustration for doctors and physicians. Two major causes of concern for providers are clauses that require patient engagement and the apparent lack of control physicians are facing in meeting Stage 2 requirements.
According to Dr Zimmerman, an Ohio based physician, the requirements in Stage 2 for patient engagement are especially worrying for most physicians. 5% of patients will have to “view online, download and transmit” their medical record for the provider to meet the requirement. According to Dr Zimmerman and several other physicians, they cannot guarantee the 5% patient engagement requirement even if they are able to send them the electronic records within a stipulated time frame. They believe that it is close to impossible to ensure patient compliance from home, adding that this is something beyond their reasonable control.
Others have argued that they do not have a great deal of control in achieving Meaningful Use. They believe that only hospitals are benefiting from the incentives while physicians are being forced to add extra processes to their treatment which is eventually slowing down their workflow instead of facilitating it, thus lowering their compensation.
While these concerns might be legitimate in their own right, hospitals can, through consultation, work out these issues because physicians are the backbone of healthcare delivery. There seems to be no going back for providers since the social benefits of Meaningful Use significantly outweigh any professional concerns within the care continuum.