The concept of meaningful use has many supporters. Its execution, however, has its fair share of detractors. Even the most ardent proponents of meaningful use recognize the deficiencies present in the certified EHR technology required by the EHR Incentive Programs.
“Meaningful use has pushed our industry to do something in the best interest of our citizens and patients that the markets weren’t pushing,” says Dereesa Reid, CEO of Hoag Orthopedic Institute in Irvine, Calif. “I want to stay on the meaningful use journey. I think it’s a good thing. I don’t think as a purchaser of healthcare IT I have the products or solution in the market.”
With many eligible providers having already invested their resources in adopting meaningful use-approved systems and services, they are more or less stuck trying to squeeze as much value as they can from their current EHR solutions.
“The key vendors in the market are doing a good job, but what has happened is that we have taken the existing healthcare EHR technology as far as it will go,” Reid explains. “We’ve gone to the edge of what we can do and now we’re starting to spend a lot of time and money on systems that I don’t think are going to get us to next week.”
A major concern for Reid is the exchange of health information which she does not consider fluid enough to support healthcare reform, namely changes in reimbursement where value rather than volume is rewarded at the level of population.
“You have to start somewhere, but as we begin to enter into population health management bundled payments and become actively involved consumers of our healthcare, we got to be able to have information that is connected,” she maintains. “If our information is buried where we cannot look at it, we will not be able to see early indicators of things that might be going on in our population where we can intervene or even be a participant.
The healthcare CEO has a sense that despite all the adoption of EHR and health IT systems by health systems, hospitals, and physician practices, this could actually reproduce another siloed environment, which is what the industry should be aiming to avoid.
“Currently, we are working to meet meaningful use for our patient portal and are on target to do that,” Reid reveals. “The patient portal has a lot of opportunity to consolidate your health information, but in most instances that I have seen all we’re doing is building a bigger silo.”
To ensure that this latest attempt at healthcare reform is not squandered, Reid advocates an increase in the dialogue among industry stakeholders and the establishment of clear goals.
“We need some clarity of thought because to continue to spend and invest in systems that probably aren’t going to take us out to the future is not going to be a good thing,” she argues. “Does it mean that we rip out all systems? I don’t know. I would hope that we have current EHR vendors realizing that they need to step up and be a part of this.”
Meaningful use involves a big amount of money: billions in incentives to eligible providers, more so to the EHR vendors whose systems they had adopted. As the industry shifts toward a value-based approach to care delivery, patients will more and more assume the role of consumers, which in turn will require providers to be more discriminating in how they treat their customers.
“If reimbursement is going down, we have to always vet our decisions about how they provide value and we can recover that cost. There’s a very serious value proposition we’re having to make, and that’s good. It should be that way — we should be good stewards anyway,” says Reid.
Meaningful use is only in its second phase, but early results from Stage 2 are underwhelming. Could it be the case for providers that the meaningful use journey is already over when it has only just begun? The latter half of this year should provide answers.
Date: May 12, 2014