Health IT

Government should slow down meaningful use implementation so providers get it right

fast speeding carThe potentially life-threatening problems caused in part by illegible handwriting and inconsistent patient information that’s been so common with paper files are diminishing as the use of electronic medical records increases. That’s one of the findings of a new survey by a Web-based electronic medical record company.

About 34 percent of the 1,700 physicians surveyed by the San Francisco-based Practice Fusion said EMR systems helped avoid serious medical errors. About one in five said they saved lives.

That support for EMR systems is underscored by Pennsylvania’s Patient Safety Authority, but with the caveat that it’s not a perfect system and needs constant vigilance since any inaccurate information entered into or generated by the records will be seen by more people, and potentially amplified.

At their best, electronic medical records can make patient data more transparent, improve patient safety and lead to better outcomes. But the ability of healthcare providers to carry out the meaningful use requirements, particularly when it comes to sharing patient information, let alone accepting patient-generated information from apps, are only as strong as the ability of these systems to communicate with each other efficiently. As healthcare systems feel the fatigue of meeting meaningful use implementation deadlines at the pace the government wants or face penalties, groups like the American Medical Association are questioning how strong these EMR systems will be in the long term if they’re not sufficiently tested.


Among the biggest concerns that healthcare providers and third-party IT vendors share is making sure different health IT systems can communicate with each other. Because if they can’t, what will happen to health information exchanges?

In a recent interview with Forbes, even Johns Hopkins seemed to bristle at the pace of change being demanded of it and other healthcare institutions. The complaint is that work with doctors on innovative ways to improve patient outcomes has taken a backseat to implementing the government rules. Stephanie Reel, Johns Hopkins vice provost for information technology and chief information officer, said:

“We don’t know what’s working and what’s not working. …We’re sacrificing innovation because of requirements to be compliant. The trade off is stark.”

If the CIO of Johns Hopkins, not exactly an institution associated with heel-dragging Luddites, takes issue with the pace of change, how well can smaller institutions be expected to cope with it? That should give us all pause.

But as if that were not enough, HIMSS Electronic Health Record Association, a group that represents the health IT companies that are helping providers meet the HITECH Act requirements, is asking the government to apply the breaks and delay stage 3 meaningful use implementation until three years after stage 2 begins. Why? Because “providers and vendors are finding that meeting specific meaningful use requirements is squeezing out other customer-desired functionality changes and developer innovation including areas related to usability and accountable care.”

Don’t get me wrong. I understand the need for the carrot-stick approach the government is taking with incentives for early adopters and penalties for those who join the process late. But these requirements shouldn’t be insensitive to the concerns voiced by providers. If the biggest concern being voiced by healthcare providers is simply ensuring that what is being asked of them can be road tested and developed in a way that’s workable for them, they should be able to submit reports demonstrating they are serious about implementation by outlining their progress as a sign of goodwill and support for the goals the meaningful use requirements sets out to achieve.

The consequence of turning a deaf ear to these concerns is producing substandard systems with the potential to cause greater harm than the shortcomings of paper-based records for the very reason EMR systems are so highly regarded — because they are interconnected with so many other systems and seen by many more people.


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