Yul D. Ejnes, MD, an internist in Cranston, Rhode Island, says that his 100-physician group was able to exchange the requisite care summaries. But he is concerned that it would be a much bigger challenge to meet the higher stage 3 thresholds for information exchange and patient engagement.Ejnes, who views the new CMS stance as a “positive development,” notes that when he receives a care summary from another provider or a report from a hospital, it arrives in the form of a PDF document. He has to leave his workflow to find the document, search for the data he needs, and come back to the electronic chart. If he wants to add that piece of data to the chart, he must enter it manually. “There’s nothing that’s extractable” in PDFs, he says.
Terry Hashey, DO, who leads a two-doctor family practice in Jacksonville, Florida, also was able to exchange care summaries as part of his attestation to Meaningful Use stage 2. His EHR can route individual data elements from a standardized clinical summary into the correct fields. But this takes eight to 10 minutes per chart, because he has to click on each piece of data to acknowledge or delete it. In the end, the information he received from other providers was not helpful. So he just accepted enough care summaries to meet the Meaningful Use requirement.
One reason for this disconnect, Hashey says, is that the EHR vendors are being pushed to meet short deadlines for certification, so they do a “halfway job” and are too busy to improve their products.
Hashey is concerned about the stage 3 requirements, but he also worries his practice won’t be able to keep up if CMS ends stage 3 and introduces the MIPS program too rapidly. What could happen, he says, is that the government “will require me to use a technology that doesn’t exist to modify patient behavior that I don’t truly control with a deadline that is unfair.”
Hashey says his practice will continue trying to improve quality and outcomes. That fits with the shift in the Meaningful Use program’s emphasis from checking boxes on technology use to improving outcomes with the help of EHRs. But that goal won’t necessarily be easier for physicians to deal with than is the Meaningful Use program.