Wednesday, January 13, 2016

Meaningful Use Is Going to Be Replaced – #JPM16 | EMR and HIPAA

Meaningful use is facing strong resistance from providers.

Despite graphic presentations such as this one:

During 2015, over 200,000 doctor's flatly rejected MU II for any number of reasons, indicating one year ago they had no plan to be able to accomplish that federal mandate due to cost, lack of vendor support, or outright rejection of the federal mandate's effort to collect 'big data' for analysis. (JP Morgan annual healthcare conference in San Francisco.)

Even prior to this John Lynn (The HIT Consultant) had a plan to blow up Meaningful Use.

"If you live, work, touch healthcare IT, then your world has been dominated for the past 3-5 years with something called Meaningful Use. The concept is a good one. The government gave $36 billion of "shovel ready" (Sorry, I just love the irony of the shovel ready stimulus being only half spent 5 years later) stimulus money for Electronic Health Records (EHR) and wanted to make sure that doctors would actually be "meaningful users" of the EHR software. Where this falls apart is that much of meaningful or that many of the meaning has already been achieved."

Among the current 'buzz words' this decade are big data, analytics, predictive modelling, mobile health, telemedicine, algorithms and more.. The feds ambition to employ more statisticians and/or keep CMS and/or their contractors occupied has been judged by providers to be a well intended goal, which should be overidden by common sense. effort. Meaningful use has no relationship to quality of care, nor the functionality of the electronic health record. 

Figures such as $ 15 - $ 20 billion have been quoted for the cost of M.U.  While this may be a small percentage of the total CMS expanditures it is not a small number.  The alternative allotment of these funds could be put to better use, and there are too many to outline here (This goes well beyond the scope of this article)

Federal ambition to harness EHR usage is stumbling badly.  The usual lemming behavior of providers to follow 'leadership' is rapidly being replaced with "I am mad as hell, and I am not taking it anymore".

Common sense has been replaced with Orwellian thought  and 1984 (Franz Kafka) thinking that government will control it all.   In some sectors this has taken place in the U.S. and around the world.

This is not to say that analyzing the cost of 18% of the GDP is not worthwhile. 

I expect this is just the beginning of the provider revolt sparked by the Affordable Care Act.  and
fueled by poorly conceived mandates of the law.

The 2016 elections and partisan discord may override thoughtful process as to where we go from here. At the least we will see significant amendments to the ACA, or an outright dissolution and replacement with a thoughtful replacement.

Nancy Pelosi was correct in her prediction "We won't know what is in it until we pass it"

Her statement was accurate and expressed even her doubt about the ability to plan health care in a monolithic law.  We now what is in the ACA. is a reflection of the comlexity of the American health system....

Stay tuned.


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