Thursday, July 15, 2010

Is what you do meaningful enough?

One doesn't usually look to the Federal Register to define meaning or purpose (philosophers, yes, but bureaucrats?), but yesterday, the federal government officially ruled on what constitutes "meaningful use" - for the purposes of distributing dollars to clinicians for electronic health records.

The Wall Street Journal's health blog has an excellent synopsis of the rule and the reaction from different interest groups and experts, and the New England Journal of Medicine has a very clear explanation and summary of its key elements by David Blumenthal, MD, FACP, the federal governmen'’s coordinator of health information technology.

Dr. Blumenthal writes that:

"The meaningful use rule strikes a balance between acknowledging the urgency of adopting EHRs to improve our health care system and recognizing the challenges that adoption will pose to health care providers. The regulation must be both ambitious and achievable. Like an escalator, [it] attempts to move the health system upward toward improved quality and effectiveness in health care. But the speed of ascent must be calibrated to reflect both the capacities of providers who face a multitude of real-world challenges and the maturity of the technology itself."

The final rule appears to offer substantially more flexibility and addresses many - but not all of the concerns - that ACP expressed about an earlier proposed rule.

The final rule has enormous stakes for internists and other clinicians, since it will largely determine who will be eligible for a piece (as much as $44,000 from Medicare or $63,750 from Medicaid, per clinician) of the $27 billion in recovery act dollars to be distributed to clinicians whose EHRs comply with the "meaningful use" requirements.

The final rule, though, wasn't the only big development yesterday on electronic health records. The American College of Physicians announced a new, free, online community, called AmericanEHR Partners, to help practices compare EHRs and learn about meaningful use. AmericanEHR Partners was founded by ACP and Cientis Technologies and currently includes eight participating professional societies and 16 participating vendors. ACP's announcement says that the AmericanEHR Partners site will help practices:

- Evaluate readiness to adopt an EHR and provide a list of recommended resources to help overcome identified challenges;
- View comprehensive EHR user ratings on different solutions (ratings are based on surveys of physicians conducted through their professional societies);
- Sort EHR solutions based on medical subspecialty and desired functionality; and
- Provide side-by-side comparisons of EHR systems.

The site also provides educational content though newsletters, podcasts, webinars, blogs, and more.

As a final rule, the "meaningful use" may be the federal government's definitive ruling on what you and your EHR will need to do to access federal dollars, but AmericanEHR Partners provides the practical roadmap, from an unbiased and trusted source, on selecting an EHR that best meets your needs and also satisfies the government's requirements.

Today's questions: What is your reaction to the meaningful use rule? And to ACP's announcement of the AmericanEHR Partners site?

1 comment :

ryanjo said...

Despite involvement with national medical IT initiatives by both the Bush & Obama administrations, Blumenthal and his proteges have failed to set standards that network diverse EHR offerings, and (looking at EHR adoption rates) have not convinced most physicians that EHRs will improve health care quality or reduce costs.

Moreover, the complex requirements of "meaningful use" mainly serve the EHR companies (who, not surprisingly, had a hand in developing the rule), by scaring doctors into buying extra assistance and complex EHRs which purport to meet the criteria.

With his ridiculous statement that failing to jump on the EHR bus is "unethical", Blumenthal holds the stick close, but the carrot just out of reach.

ACP's response to the final rule? Again, feeble and reminiscent of the PPACA endorsement: "Well, we got part of what we wanted." The ACP membership can only dream for a tough approach by our leadership to government meddling in medicine. Consider the victory by the National Automobile Dealers Association, successfully avoiding new government restrictions for auto transactions in the financial reform bill. Whatever your opinion on this outcome, their leadership got the job done for their members...and ours didn't.