We have written previously about the "Meaningful Use" electronic health record (EHR) initiative, which is run by the Centers for Medicare & Medicaid Services (CMS). As a brief refresher: Under the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act (part of the Recovery Act), hospitals and healthcare providers must be able to demonstrate by 2015 that their EHR systems are capable of certain tasks that constitute "meaningful use." Some important updates on meaningful use and electronic health records are found below:
Slow Start for Meaningful Use
Recently, it was reported that in 2014, meaningful use has gotten off to a slow start according to data unveiled by CMS. During a meeting of the Health Information Technology Policy Committee, Elisabeth Myers of the Office of eHealth Standards and Services at CMS provided meaningful use attestation data through July showing that a total of 2823 eligible professionals (EPs) and 128 eligible hospitals (EHs) have attested for the 2014 reporting year. Of those eligible providers, 972 EPs and 10 EHs attested to Stage 2 during their 2014 reporting year.
While the number of attestations doubled between June and July, that does not equate to a double in the number of providers attesting. As it stands, roughly one percent of all EPs and three percent of EHs have attested in 2014. Despite those figures, CMS is advising against reading too much into them.
"I think it is actually a little bit dangerous to try and apply those types of interpretations to these particular numbers because they don't necessarily mean that," Myers claimed during the meeting, as reported by EHR Intelligence. "They are meaningful and they do provide us with some information, but as far as datasets go there is some difficulty comparing these in those types of ways."
As Myers went on to explain, these data are not reliable enough to support a comparison to previous reporting years and stages of meaningful use. In fact, they may say little about how the rest of the year will play out for eligible providers.
"As of that date, there has only been one potential reporting period and that's that first quarter," she emphasized. "For eligible hospitals, there have only been two potential reporting periods and those are the first and second quarter reporting period."
Hospital Progress in Transition to Electronic Health Records
As reported by Fierce EMR, hospitals continue to make progress in the transition to electronic health records, although adoption still varies widely. According to a new data brief released by the Office of the National Coordinator for Health IT, based on the American Hospital Association's annual health IT survey, roughly nine out of 10 hospitals have certified EHR technology--up 29 percent since 2011--and 59 percent have an EHR with advanced functionalities--an increase more than eight-fold in the last four years. Roughly six in 10 hospitals electronically shared data with outside providers, a 51 percent increase since 2008. However, adoption varied significantly by state, ranging from 26 percent to 83 percent.
In a related blog post, Matthew Swain, a program analyst with ONC's Office of Economic Analysis, Evaluation and Modeling and Erica Galvez, ONC's interoperability and exchange portfolio manager, noted that ONC anticipates that exchange of care summaries will increase as hospitals move to the 2014 edition of certification criteria, which requires more interoperability.
Study: Meaningful Use Not Linked to Higher Quality Care
A recent study from JAMA Internal Medicine, "Meaningful Use and Quality of Care," has cast some doubt on the $25.8 billion that the American Recovery and Reinvestment Act has apportioned for electronic health record (EHR) incentives.
As reported, the cross-sectional study of 858 physicians—63% of them defined as meaningful users of EHRs—found that "despite hope that achieving meaningful use improves quality … meaningful users did not consistently provide higher quality care," researchers wrote.
The study took place at the end of 2012 in Boston's Brigham and Women's Hospital. At the time, the hospital used its own in-house system and followed stage 1 of the meaningful use requirements (data capture and sharing).
Both the study's authors and the invited commentators found common ground in one conclusion—that more research is necessary: "Ongoing evaluation is critical to understanding the effects of the transformative MU [meaningful use] program, not only on patients but also on the healthcare system," the commentators wrote.
This is not the first time that there appears to be a disconnect between the Meaningful Use measures and quality. The General Accountability Office recently warned that the program's clinical quality measures were "unreliable."