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Meaningful Use: Defined by HIT Policy Committee

Carrie Vaughan, for HealthLeaders Media, June 16, 2009

The IT community is one step closer to a definition of "meaningful use" of electronic health records since the HIT Policy Committee made its recommendations today to the Office of the National Coordinator for Health Information Technology.

I spoke with a number of executives to get their predictions and strategies regarding "The Meaning of Meaningful Use" for the June issue of HealthLeaders magazine. Since then, I've spoken to even more industry executives to get their thoughts on the phrase that has caused confusion, criticism, and alarm. Here are some excerpts from those conversations.

Will the bar on "meaningful use" be set too high or too low to improve quality?
That is a real risk, says Lynn Vogel, MD, vice president and chief information officer at The University of Texas M. D. Anderson Cancer Center. "Since these are 'stimulus' funds and likely a one time opportunity, I am concerned that there will be a temptation to expect that they will fix all that ails our healthcare system and that is completely unrealistic." It's not IT's burden alone to improve the quality of care, says Vogel, who is also the associate professor of bioinformatics and computational biology. "Hospitals should not be penalized if all they have done is to improve the caregiver's access to clinical data through electronic capabilities. That is valuable and 'meaningful' by almost any standard," he says.

The government will not hold organizations "hostage" to high standards, says Mark D. Crockett, MD, an attending physician at Morris (IL) Hospital and the president of the emergency care division for Picis, an Wakefield, MA-based IT software vendor. "It will be more of a carrot than a stick," he says. "They are looking to reward hospitals that are making moves—reporting quality and using some type of CPOE. They are also looking for information exchange."

Are the stimulus funds a big enough 'carrot' to spur quick adoption, or will most organizations just try to avoid penalties?
The answer is different for hospitals and physicians, says J. Marc Overhage, MD, PhD director of medical informatics and research scientist at Regenstrief Institute, Inc. and president and CEO of the Indiana Health Information Exchange. "For hospitals it is probably enough," he says. "For physician practices, by and large, it is not enough."

The combination of incentives from the Centers for Medicare & Medicaid Services and the American Recovery and Reinvestment Act removes any doubt that physician practices must adopt an electronic health record in the next five years, says Phyllis Schuck, CIO at Pinehurst Surgical Center. "The financial aspects are designed to encourage rapid adoption." But they don't "significantly offset" the capital outlays that an EHR requires, she says.

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