Opinion: MU is failing, but it's not too late to fix it

The healthcare industry generally has negative sentiments toward meaningful use regulations, and with good reason. However, the federal EHR incentive program isn't necessarily a lost cause, suggests Niam Yaraghi, PhD, a fellow in the Brookings Institution's Center for Technology Innovation.

In a contributed blog post for U.S. News & World Report, Dr. Yaraghi writes that meaningful use is failing, largely because of the way the initiatives were and are being implemented.

Stage one of meaningful use was focused on the adoption and implementation of EHRs, which was pretty successful. Stage two is where providers ran into trouble, according to Dr. Yaraghi.

"Although policymakers' hunch about the benefits of IT was correct, it failed to understand a nuanced condition under which this magic wand works: organic and voluntary adoption," he writes. "Imposing these records on the medical community and forcing them to adopt and use this technology was destined to fail."

However, Dr. Yaraghi says there is still time to correct the course. First, the healthcare industry needs to acknowledge and understand the reasons why stage two failed. Otherwise, the industry won't be able to learn from past mistakes as it moves forward.

The failure of meaningful use is that its goal is off-target, according to Dr. Yaraghi. Instead of being focused on using EHRs as a means to achieve an end — efficient, high quality care — meaningful use is too focused on the adoption and implementation of records as the final goal. What's more, meaningful use only offers EHRs as the sole IT solution providers need instead of considering other types of solutions, Dr. Yaraghi writes.

Dr. Yaraghi says meaningful use should be a capitated payment model, where providers received a certain amount of money per patient and provide the best care they can at the lowest cost. Doing so identifies the fact that providers are all different and meaningful use's current one-size-fits-all approach isn't the best-suited for such a varied industry.

"HHS should have set efficiency as a goal and let medical practices to find out the best way to achieve it through healthcare IT of their choosing," Dr. Yaraghi writes. "Instead of mandating physicians to record the smoking statues and vital signs of all patients, send them reminders about their follow-up visits and communicate with them through secure electronic messages, meaningful use incentives could have been allocated to fund a wide variety of different IT solutions suggested by medical providers."

Moving forward, Dr. Yaraghi suggests conduct a pilot project to test this new approach. If HHS submits a call for proposals for IT projects designed by providers to address their unique issues and cut costs and improve quality, it will design a sort of national lab to test many different IT solutions.

"This approach will open up the market for meaningful and innovative IT solutions that actually help medical providers improve their efficiency," Dr. Yaraghi writes. "Medical providers will find their best way to be more efficient and will adopt the IT solutions that best fits their needs organically and voluntarily. Only then IT will work its magic in the healthcare sector."

More articles on meaningful use:

CHIME to Senate: 6 health IT challenges and solutions
Former hospital CFO receives 23-month sentence for lying about meaningful use
The state of HIEs and direct messaging: 18 key findings from HIMSS


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