Achieving Meaningful Change from Meaningful Use

By Kim LaFontana, vice president, Ingenix

On July 16, the federal HIT Policy Committee approved the final recommendations for “meaningful use” of electronic health records (EHRs). As health care professionals know very well, “meaningful use” is currently a critical and highly debated term in Washington, D.C. and the industry at large. The term stems from the American Recovery and Reinvestment Act (ARRA) – otherwise known as the stimulus bill – which has appropriated funds to be invested in health information technology at a level unprecedented in this country.

Among the ARRA investments is over $19 billion of funding for physicians who implement electronic health records (EHRs) in their practices. Yet, the funding incentives aren’t without conditions. In order to be eligible for government funding, physicians must demonstrate “meaningful use” of EHRs.

At Ingenix, we’re working round the clock not only to provide innovative health information and technology solutions for our clients, but also to help physicians and policy makers determine the best path for investing in health IT, and for defining meaningful use. Given our experience with providing the CareTracker EMR solution to physician practices and our work implementing EHR systems in hundreds of hospitals across the country, we have valuable input to offer.

In April, we submitted testimony to the initial hearings on meaningful use held by Dr. David Blumenthal, National Coordinator for Health IT. Our comments were unique in stating that Meaningful Use must be guided by goals for Meaningful Change, specifically:

• Convert information into insight: Enabling better, more insightful and more consistent decision making at the point of care and throughout the health care system by combining detailed patient information, care history and medical knowledge
  
  
• Evolve the roles of key participants: including vendors, physicians, payers and patients. For example, product developers need to deliver user-friendly solutions that enable care givers to improve outcomes; physicians must embrace the transformative affect of the technology on their practices; payers must align pay-for-performance incentives with meaningful use; and patients must be committed to their care and to making informed decisions
  
  
• Use the power of the internet: Removing disparities in care by using affordable, web-based solutions like CareTracker to ensure physicians in remote and underserved communities have access to best practice and evidence-based medicine

In addition to emphasizing the need to achieve meaningful change, we also recognize that understanding where physicians are coming from is essential to delivering technologies that support and improve – rather than interfere with – their practices.

A recent Ingenix survey of over 500 physicians’ attitudes toward EHRs offered some startling insights. We found that while half of those surveyed had little or no familiarity with the ARRA or its HIT provisions, the vast majority (86 percent) are likely to adopt an EHR solution because of the new financial incentives. In spite of this intent, however, significant numbers respondents don’t plan to utilize many of the features most experts believe essential to meaningful use, including evidence based medicine (24 percent), e-prescribing (20 percent), and using online tools to access accessing patient drug histories, allergies or other medical history (29 percent).

These findings underscore the very real challenges to achieving the goals of EHRs. True transformation of underlying issues of waste, misuse and sub-optimized care delivery requires more than applying technology to existing workflows but instead adoption of new capabilities to make better decisions.

The survey results became useful in shaping further recommendations to tie each of the stated objectives of meaningful use to specific end-state measures. So we fully support the HIT Policy Committee’s final recommendations, which included a meaningful use matrix that aligns specific measures with stated objectives for each phase of implementation.

As we continue to work in partnership with physicians, government officials and policy makers, we do so with the intent to make life easier for the people who use health IT, so they can make patients healthier. Ultimately, we want to optimize the precious 15 minutes patients have with physicians by providing the right information at the right time and place. We are committed to contributing our information, knowledge and experience to the conversations that will drive modernization of our health system. Done wrong, investment in health IT can be a huge disappointment. Done right, it will improve quality of care, reduce costs and eliminate social and geographic disparities in access to quality care.

We’re in the right position to help – and we will.

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