Thursday, April 30, 2015

#‎NoMUwithoutMe. Has the Patient been Left Out ?


There is now a debate raging over ‪#‎NoMUwithoutMe.  Several patient advocates have been swept up in a debate over a non-issue regarding meaningful use.  The  term itself is meaningless to most physicians.

To what group does meaningful use apply ?  Is it providers, analysts, medicare, or patients>? The group caught in the middle are the vendors.  That is where the rubber meets the road…

Several  hundred providers have already adapted stage I of meaningful use, while there has been more reticence to adopt stage II .

The artificial incendiary action was CMS proposal to shorten the attestation period from one year to 90 days for the next stage of M.U.  This, in response to provider pushback regarding the overwhelming confluence of conversion to ICD-10, something effecting every EHR. Many are saying to hell with the incentive, I’d rather get penalized. The increase of time, loss of efficiency and investment of more capital does not equate with better medical care.

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According to Adrian Groper M.D. writing in The Health Care Blog…..the patient is being left out of the end game and recipient of their own health data.  Some of this becomes highly technical as to what a patient can download from a patient portal.

To quote Dr. Groper,

“Meaningful Use (MU) requirement for Stage 3, in the final stage of a $30B + initiative to advance interoperable digital health records. The focus is on something called View / Download / Transmit (V/D/T) but the real issue and the Last Chance is broader and more important. The bad news is that MU may leave patients as beggars for own data. The good news is that the Office of the National Coordinator (ONC)  and Congress are paying attention and patients still have a chance to shift the terms of the debate to what HIPAA calls “the patient’s right of access” and demand that it apply strictly to MU Stage 3 Appication Programming Interfaces (API).”

So, at this point in time MU stage III is dead on arrival with a required re-definition of what it will require from software APIs.

What makes this even more interesting is that many large health systems have already included MU III in their new software.  Large healthcare systems have considerable capital to send to software vendors, in contrast to smaller hospitals and medical groups.

Meaingful use has become fodder for the software industry, and does need to be re-directed toward patients. The bottom line is if it ain’t good for the patient/provider….don’t do it. Primum non nocere.

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