As we come up on the dates where EHR/EMRs need to be certified to support Stage 2 of Meaningful Use (MU), I just saw another article urging that Stage 2 be delayed (coming from the AMA in this case1). I thought it would be worth taking a look at where we have been and where we are going on the MU journey, and perhaps speculate on what will happen with Stage 3.
Before the MU program was launched, EHR adoption among ambulatory providers was modest, perhaps 15% depending on whose numbers you looked at. And adoption wasn’t increasing very rapidly. The goals of MU Stage 1 were a) to define some minimal capabilities an EHR had to have, to test EHRs to assure they had those capabilities, and b) to provide incentives for providers to implement an EHR and start using it. As measured by those limited criteria, Stage 1 was a success: EHR adoption rates are now over 50%2, and thousands of providers have successfully attested to their use at least at this basic level.
The MU program had several negative side effects, however. The limited set of MU Stage 1 requirements attracted a large number of new entrants to the EHR market, many with limited products built just to meet the certification criteria, not to provide good workflows or improve patient care. Providers unfamiliar with EHRs had a tough time selecting one that would be cost-effective in the long term, and tended to focus too much on license /subscription costs.
Meanwhile, established EHR vendors had to reprioritize their development activities to meet the MU certification deadlines, and their customers had to go through expensive and complex upgrades that didn’t necessarily help their practices.
While there were rough spots in the process, I think the consensus was that MU Stage 1 was worth doing, and the bar needed to be raised in MU Stage 2. As we near the end of the Stage 2 development process, some may be having second thoughts.
The wide-open market that existed for vendors a few years ago no longer exists. MU Stage 2 alone will probably not increase EHR adoption rates among providers. Vendors who built basic MU Stage 1 products are struggling to extend them for unforeseen MU Stage 2 requirements. Established vendors have had to postpone product innovations yet again to meet the MU Stage 2 criteria. And there is a growing dissatisfaction among providers that the MU program isn’t really improving patient care or the operation of their practices. Career dissatisfaction among primary care providers is at an all-time high.
The proposed capabilities for MU Stage 3 are currently under discussion, but there is a separate discussion occurring in the industry about whether MU Stage 33 makes sense at all. With the leadership change at the ONC, and against a political backdrop that questions the value of the whole incentive program, things are very uncertain.
Meanwhile, real innovation is occurring in parts of the industry not tied to the Meaningful Use EHR program: long term care EHRs, cloud-based systems for care coordination, and improved decision support around diagnostic testing. So while the Meaningful Use program has helped jumpstart HIT adoption, a different mechanism may be more valuable going forward.
Pat Wolfram, Liaison Healthcare’s Director of Product Management, EHR and Lab Integration, did a webinar that discusses the upcoming Meaningful Use requirements and how EMR-Link helps you meet many of them. Click here to view the webinar.
VP of HIT Strategy
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