Physicians want the ONC to halt Stage 2 of Meaningful Use and to reexamine Stage 1 progress and EHR adoption rates. In an open comment, the AMA told ONC that the current approach it is taking to ensuring Meaningful Use through financial incentives will not work. They said that physicians want to qualify for incentives, want to adopt EHRs, but the requirements for Meaningful Use are currently burdensome and need further investigation. The AMA suggested five priority actions to address their most pressing concerns:
- Survey physicians who did and didn’t participate in Stage 1 to identify barriers and solutions
- Meaningful Use should account for appropriate use
- Measures must be studied before making them core requirements
- Criteria should only be established for objectives where robust tools required to achieve them already exist
- Any criteria that are dependent on a third party (such as a patient) should be removed
I believe that all of these are significant concerns and valid ideas. The difficulty lies in ONC’s need to balance providers’ needs with the realities of product development lifecycles. ONC is anxious to release criteria for stage 2 in an effort to allow vendors significant time to build out required functionalities. Further, ONC is attempting to achieve Meaningful Use with a politically feasible timeframe. The process is thus a delicate balance of provider needs, vendor capacity, and politics.
The view of the AMA appears to be that providers are expected to bear the burden of achieving Meaningful Use with ineffective tools and non-incentivized third parties. For example, a provider that purchases a legacy EHR may be expected to maintain his or her practice while:
- Learning how to use the new software;
- Engaging the vendor and lab provider to ensure integration;
- Working with the vendor and hospitals to create unique connections; and
- Establishing information exchange with HIEs.
These tasks require too much of a provider’s attention and should not be his or her full responsibility. It serves only to distract the provider from his or her primary purpose: taking care of patients. The provider needs a partner.
Vendors share responsibility for enabling providers to most easily achieve Meaningful Use. As I discussed in a recent blog post, not all certified EHR products are created equal and most vendors have paid little attention to their customers’ urgent Meaningful Use needs. I believe this is why the AMA has released such a strong public comment.
Practice Fusion is working hard to make the Meaningful Use challenge easy to navigate and achieve at no cost to the provider. For example, Practice Fusion offers an intuitive product and provides unlimited training, manages the lab integration process, has a large user base that enable easy referrals and seamless information exchange. Practice Fusion is ensuring that providers have the human resource and mental capacity to dedicate to their primary mission. This is the appropriate orientation for an EHR vendor.
As the ONC decides how best to proceed with Stage 2 of Meaningful Use, providers should feel confident that there are vendors who will strategically and thoughtfully build features that will facilitate easy achievement of future criteria.
Thomas McMennamin
Health Policy Manager
Practice Fusion EHR
