The meaningful use program is a loaded term in the healthcare industry.
On one hand, it has likely driven the rapid adoption of EHRs, e-prescribing and HIEs. On the other hand, meaningful use attestation has lagged, and physicians complain of its excessive burden and cost to their practice. As the ONC drives the conversation about wider HIE implementation and interoperability, the need for more physician practices to attest meaningful use is critical, according to a blog post from the Brookings Institution.
Here are four current challenges to meaningful use attestation in the value-based care environment.
1. Meaningful use requirements are rigorously uniform. Although the certification process has provided standards, they aren't flexible in terms of the size of the practice or type of provider. This approach does not work across the spectrum — for example, a chronic pain specialist requires much more extensive documentation than a cosmetic surgeon, but they are required to meet the same set of standards, according to the blog post. The American Medical Association has vocally opposed the meaningful use set of standards and repeatedly called for CMS to ease them.
2. Many practices have had to abandon their EHRs for meaningful use-certified ones. Before the meaningful use program was installed, physicians and practices had developed their own EHR systems in a somewhat patchwork fashion and learned how to document efficiently on those systems. However, when the program was put into place, may of them had to abandon those system and learn a new one, requiring both financial resources and employee time. Stage 3 of meaningful use is supposed to focus on patient outcomes, but the transition on how to focus from health IT process measures to quality is still unclear, according to the post.
3. Accurate, actionable information on coverage and payment has been hard to obtain. Reimbursements are declining and procedure costs are increasing, but accurate and actionable information about coverage and payment have been difficult to locate through the meaningful use program. This has led to physicians and patients going outside their EHRs for payment information, leading to potentially higher costs and delayed or denied services. This inhibits the best patient outcomes, according to the post.
4. Interoperability has been sparse. Even if EHRs are interoperable with one another or within a system, insurance companies and employers often do not accept information in an EHR's format, often requiring duplicative documentation. Future plans for interoperability are not based on current systems but rather future systems to be developed, incurring more time and cost to the practices. The Brookings Institution suggested placing more emphasis on relevant payment-related information.