“Meaningful” HIT: Putting Teeth in ARRA HIT Provisions
By Josh Seidman | Popularity: 8%As I’ve discussed before (here and here, for example), there are a number of ways that implementation of the HIT provisions from the American Recovery & Reinvestment Act (ARRA) will shape its success. To go deeper into the issues involved, just consider the potential power of “meaningful use” definitions to drive a better health care delivery system.
Among the most important HIT provisions in ARRA involves physicians needing to demonstrate “meaningful use” of electronic health records (EHRs) in order to be eligible for up to $44,000 in incentives for EHR adoption. At the Health Affairs briefing yesterday that promoted the release of their HIT theme issue, some of the panelists provided some thoughts on the meaningful use carrot.
For example, Farzad Mostashari, MD, who heads New York City’s Primary Care Information Project, suggested that it’s important that HHS creates high expectations for meaningful use to ensure that clinicians are not just automating ineffective care processes. Mark Smith, MD, MBA, President of the California HealthCare Foundation, somewhat addressed this, saying that one of the three public policy issues that we need to get right if HIT is going to succeed is the “maze of regulations that protects incumbents in health care” because “the purpose of [HIT] is not to wire the incumbents to do everything” the wrong way.
Absolutely true! But we need to go even further. Specifically, “meaningful use” should address the question, “Meaningful to whom?”
Consensus exists that — ultimately — HIT is a means, not an end. The end is more efficient, less expensive, and better health & health care for consumers/patients. Therefore, clinicians should get credit for EHRs that provide “meaningful” information to consumers. If HIT tools aren’t helping consumers make better decisions, effect positive behavior change, and manage their health, the tools aren’t meaningfully changing health care.
The HIT Policy Committee will have influence in guiding the “meaningful use” definition that the eventual HHS Secretary will be responsible for imposing. Given the enormous investment that the federal government is making through physician incentives, I think it’s fair to expect that the funds flow for technology that truly improves patient care by connecting consumers to the health information they need to lead healthier lives.
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March 26th, 2009 at 12:55 pm
[…] Incoming HHS National Coordinator for Health Information Technology David Blumenthal, MD, MPP, makes some important points about how the HIT provisions in the stimulus bill were designed to generate “improvements in health and health care” and not just increase EHR adoption. Aside from the financial incentives (and down the road, penalties) for providers and the important infrastructure created, Blumenthal highlights the critical importance of the “federal government’s skill in defining two critical terms: ‘certified EHR’ and ‘meaningful use.’” He is right that tightening certification criteria and “motivating providers to take full advantage of EHRs” are prerequisites for HIT actually improving quality and efficiency. I’ve described this and the importance of stretching out “meaningful use” to meet the needs of consumers before. […]
April 30th, 2009 at 8:14 pm
[…] The latest inside-the-Beltway, HIT version of “exciting” debate is now raging: What will constitute “meaningful use” for providers to qualify for HIT implementation incentives from the stimulus bill? The Center for Information Therapy (IxCenter) background on it can be found here. […]
May 12th, 2009 at 11:09 am
[…] turned the discussion toward the more nuts and bolts issues, Blumenthal talked especially about the issue of defining “meaningful use,” which he said is “in some ways a revolutionary concept.” The timeframe for coming up […]