Several mandates are still in effect. As Mark Segal, chair of the HIMSS Electronic Health Record Association, reminds us: "Meaningful use is forever." And EHR carries with it the long shadow of incentives and penalties which in the long run are very significant.
Many in the health and health IT industry are saying meaningful use is dead, due to it's complexity and the cost of upgrading current EMR systems to comply with CMS and HHS mandates. HIT vendors and health providers are justified in offering their opinion of non-attainability of the MU goal stage III.
Whether or not there's any such thing as a "post-meaningful use" era, there's been plenty of discussion recently of a "post-EHR era" – one in which, with the basic commodity of electronic health records now in place and in use, the technology can evolve and improve: better usability and design, mobile device interfaces, more seamless interoperability.
Although the vast implementation of EHR, MU I has taken place, many say it failed, largely because the Federal government hastily mandated a too short plan to implement it. They did the same with the Affordable Care Act. Passing both of these laws and the small print within was a political expediency...a rush to get it passed rather than a framework for success. Success cannot be measured by one factor, as to how many people have a card in their wallet which claims they have health benefits. Most people do not have better care, cannot access a physician, and cannot afford the deductibles.
It is patently obvious the regulatory burden increases each year at the expense of patient care. Much of the "quality metrics" amount to checking off the boxes to reach HEDIS and MEDSTAR rankings. In some cases patient engagement is measured by how many times an insurer calls a patient without being asked to for things such as life issues, pharmaceutical needs. In one day I received three different phone calls from Human asking me if I needed any help. I was offered a house call 'free' since they had a mobile MD in my neighborhood. It took several 'NOs" to convince the care manager that I had just seen my doctor. The next call was from another case manager...about ten minutes apart wanting to review my medication list. The third call was from another asking me how I was doing after my spouse had passed six months ago. This was a routine monthly checkup on my well-being.
On the face of it, it all seems well intentioned and that my doctors care about me. Perhaps I have become cynical....and perhaps there are patients that require this much pro-active care-giving. I am fortunate I have my wits about me (I think) even if I am 73, have had several major heart adventures and one small stroke. Since I have young adult children they manage me quite well. (there should be an opt-out for the computerized checklist. The whole thing is on automatic pilot, from voice mail to phone trees to managed care. The infrastructure eats up any savings in actual patient care, in fact it seems as if the patient care savings were designed to finance the parasitic administrative burden.
Health insurers now practice medicine, they set the standards for payment, and use practice patterns to judge the quality of care. They call patients at home without permission or knowledge by the doctor....It is all okay because I am told the call is recorded for quality measures....(who listens to these recordings?
Are we in Kansas Dorothy ?
Are we in Kansas Dorothy ?
Is the post-EHR era upon us? | Healthcare IT News