Market forces vs government regulations
While observers and medical associations give the initial phase of the Meaningful Use program high marks for converting most physicians and hospitals to EHRs, there’s a widespread feeling that stage 2 and the Meaningful Use penalties have been counterproductive. Moreover, physicians don’t understand why they should continue having to prove they are using EHRs meaningfully after having demonstrated they are doing so.
“When MIPS arrives, do we need Meaningful Use?” Ejnes asks. “I think it needs to go away. There are [performance] measures you can’t do without an EHR, so why do we need to prove we’re meaningfully using it?”
Steven Waldren, MD, director of the AAFP’s Alliance for eHealth Innovation, points out that Meaningful Use may be an obstacle to improving the quality of care. “Doctors and their practices have a finite capacity, and many times they’re taking that capacity and going through the routine of being compliant on Meaningful Use, which may or may not improve the quality of care they provide to their patients.”
Like Filer, Waldren believes that physicians are revolting against too much government regulation of their daily work. “If this continues, docs will get a sour taste in their mouth and not continue to do the transformational work that will prepare them for value-based reimbursement,” he says.
Waldren agrees that EHR vendors have lagged in areas such as interoperability, user-centered design and population health management. But he thinks that value-based reimbursement will give healthcare providers a strong incentive to demand more from them.
“We’ve been doing Meaningful Use now for five years,” he observes. “How much has it really helped us on quality and cost efficiency and the Triple Aim? I’d say it has helped us marginally, and we’ve spent billions of dollars. Will the market be able to do that? That’s a big unknown, and it may not be able to do any better.”