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Purpose of Meaningful Use

Posted on August 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Lately I’ve been quite disturbed as I’ve read all sorts of commentary about the “Purpose of Meaningful Use.” Here’s one such comment on meaningful use that I read recently:

My impression is that EMRs and meaningful use were about getting Americans to practice evidence-based and comparative effectiveness medicine towards a more streamlined and cost-effective US Healthcare System

Some of you might remember when I questioned the “meaning” of meaningful use as described by Farzhad Mostashari. So, this is not a new subject for me to consider.

Here’s the problem:

The purpose of meaningful use was to be sure the ARRA money was spent on software that doctors actually end up using. Everyone has then taken meaningful use whatever direction they want.

We can certainly talk about the possible impacts and unintended consequences of meaningful use, but let’s not confuse the possible impacts with the purpose of the legislation.

It turns out that meaningful use is actually accomplishing its purpose as I describe it above. At least in Medicare where meaningful use is a requirement there aren’t EHR companies gaming the EHR incentive money like they are in Medicaid. Sure, with self attestation you could lie about your “meaningful use” of an EHR, but I have yet to see it and think it is very unlikely.

You may have noticed that I don’t write about meaningful use as much here on EMR and EHR. That’s because on EMR and HIPAA I (with some great help) have been doing a weekly Meaningful Use Monday series over the past year. Check it out if you’re interested in the details of meaningful use.

Meaningful Use Stage 2 is Here! Are You Ready?

Posted on March 2, 2012 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

MU Stage 1 has found some slow-moving and grudging acceptance. According to this news brief from Fierce EMR, a good 42% of providers offices have already attested for MU Stage 1, while another 17% plan to attest within the next year. However, there is also a large number – 39% – who have no plans to do so in the near feature.

The reasons cited include changing technological requirements and budgetary concerns. And in the midst of all this drama, CMS is waiting in the wings with Stage 2 Meaningful Use. The Stage 2 Requirements will be published in the Federal Register on March 4 (Here’s a good meaningful use stage 2 summary for providers).

Are we truly ready for MU Part Deux? I’m not sure we are, and I’m not sure that’s the right question to ask. I’m almost giddy with the promise that MU Stage 2 offers – with greater interchange of information, in standardized formats, and public health reporting realizing its full potential. Maybe a few years into the future, I’ll break a leg skiing in the Swiss Alps and my attending physician there will be able to look up my EHR on his local software. I mean Stage 2 doesn’t come with promises of true international portability of data, but getting past Stage 2 will mean we’re that much closer to true health information flow (if we get state exchanges to effectively exchange information or significant benefits to public health reporting, CMS will declare MU Stage 2 a success.)

Even if you think MU is a load of bunk, you can still be an essential part of the process by participating in the comment stage.

Here’s a direct link to MU Stage 2 rundown published by CMS. The document has details on how you can send CMS your comments.

All comments will go on the regulations.gov website. I’m going to be watching that space in the next two months.

RECs Expanding “Preferred” Vendor List to Meet Goals

Posted on November 4, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve gotten word from a couple of different places now that a number of RECs have had to open up another RFP to increase their “preferred” (or whichever term they like to use) EMR vendor list in order to reach the number of meaningful EHR users they need to reach.

Most of you that have read my stuff for a while know how much I dislike how many of the RECs approached the EMR selection process. There are a few RECs that have done a great job of remaining neutral and supporting any and all certified EHR vendors. I applaud their efforts.

I’m just really glad that doctors weren’t fooled by RECs’ preferred vendor lists. The idea that a REC could identify the appropriate EHR vendor for such a wide variety of doctor specialties, sizes, etc is just wrong. I’m glad that the net has been widened by many RECs even if their hand seems to be kind of forced into it to meet their numbers.

I’m fine with RECs specializing in certain EHR software. There’s no way they can be experts in all 300+ EHR software. However, the EMR selection should be driven by the doctors and practice managers and then the RECs support the EMRs selected most often by the actual users.

I guess now we’ll see if RECs start searching for the low hanging fruit to meet their numbers.

Pediatrics Face Unique Set of EMR Challenges

Posted on October 26, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My recent blog about Sandhills Pediatrics and its successful implementation of an EMR prompted, fortunately, a very intriguing comment from Chip Hart, a Director of Sales and Marketing at Physicians’ Computer Company who also maintains the blog “Confessions of a Pediatric Practice Consultant: True Stories from the land of Pediatric Practice Management.” He wrote: “I’ll spare everyone the diatribe about how ARRA deals with pediatricians and how only about 1/2 of them qualify, as I write to make one quick statement.” There’s a story there, I thought to myself. So, being an avid observer of pediatric EMR news and views, I reached out to him to gauge his thoughts on where healthcare IT solutions fit in the world of pediatricians.

What sort of challenges are you seeing pediatric practices facing when it comes to implementing EMR systems?
“On one hand, most of the challenges they face are hardly unique to pediatrics: resistance to change, practice differences, the lack of time and resources to be trained and configured properly, poor support, etc.

“Specific to pediatrics, there are two major issues.  First, children are not simply small adults and EMRs, as a rule, are written for adult medicine. There are many pediatric-specific features and functionality that a pediatric practice needs that simply aren’t met by your large, generic system. Simply claiming “pediatric templates” isn’t enough.

“Second, although every specialty complains about the hit that EMRs take on their productivity, pediatricians are obviously in the worst shape. Their volume is the highest and their payment is the lowest. Just adding a minute to each encounter means an extra 30 minutes of charting a day … and I hear stories, daily, of practices adding another 1 to 2 hours! Pediatricians can’t afford to see 5-percent fewer patients. Radiologists can. And pediatricians really like to eat dinner with their families.

“One second-tier issue is that less than 50 percent of all pediatric practices don’t qualify for ARRA and the regional extension centers (RECs), as a rule, don’t understand the Medicaid rules well.  Thus, we have clients and potential clients calling us to ask how they can get money they’ll never get, or to tell us some crazy thing a REC person told them.”

Are there different sets of challenges for those that are private practices versus those that are hospital/healthcare system affiliated?
“Unquestionably – the big one being that hospital/health system pediatricians simply won’t have a choice or even a voice in the process. Yes, I’ve worked with some who appear to be at the table, but in the end … you get what they hand you. Right now, Epic is pushing everyone out but that pendulum will swing back.

Also, those employed physicians don’t have to consider the impact on their productivity in the same way. I’ve met too many peds offices whose docs didn’t take home checks for a few months after implementation – that’s not right.”

Why do you think practices like Sandhills “get it” in terms of moving forward with HIT implementations, and just being forward thinkers in general?
“If I could answer that question, I’d only be working with those practices! Every successful practice I know is successful in a different way for different reasons, but there is one common trait I see in many of them: They run their practices like the businesses they are. Keep the docs in the exam rooms, where they can generate revenue, and hire professionals to actually run the business. Just because it says “MD” after your name doesn’t mean you’re the best-qualified person to run your office. Would Dirk Nowitski or Lebron James make good coaches? I doubt it.

“In the case of Sandhills, they have some excellent, excellent staff who bring some non-healthcare experience to the table. Although I’ve seen it fail, having some management that comes from outside the healthcare system to ask and answer some tough questions pays off for a lot of practices.

“We’ve enjoyed working with them.  I should also add that they, like the other ‘heads up’ clients I know, realize that we’re on the same team. That helps tremendously.”

How long have you offered the PCC EMR? What sort of up tick in implementations have you seen since ARRA/HITECH came about?
“Our PM has had pediatric clinical features (immunization tracking, registry interfaces, well visit recall, etc.) for almost 30 years, but the official EMR itself was released about 2 years ago.

“When ARRA was first announced, we received a lot of calls, all along the lines of, “Where do I get my free money?”  It was very frustrating to explain that it would be state dependent (about a quarter of them still can’t get it) and half of our clients will never qualify due to the Medicaid requirements.

“Things are starting to settle down and get organized.  Still, we are busier right now than we have ever been. We are telling potential clients they might get installed in May or June. A nice problem to have, but it’s not fun to get some excited only to explain it will be 6 months, especially when it used to be 6 weeks!”

Are any of your pediatric clients thinking of becoming involved in ACOs?
“Thinking?  Yes.  They’re all being told how if they don’t get big, they’ll be out of business, which is utter BS. The rules, as we know them now, seem to make no sense whatsoever for pediatricians. I did see a compelling presentation by Colleen Kraft at the AAP NCE last week that very much supported the ACO-esque model she employs, but I think her situation is both unique and not potentially an ACO.

“With some issues – 5010, PCMH, etc. – we take a pro-active stance. With ACOs, I’m glad to let someone else jump first.”

How will your solutions enable your customers to integrate with ACOs or coordinated care programs?
“Far too soon to tell.  In general, I can say, “Hey, we have had really good reports that have tracked patient populations for years.”  Our clients use them all the time, as it’s both good medicine and good business.  As a practical tool, I’d put our patient recall program up against anyone’s – your front desk can crank out a list of kids who need flu shots or asthma followups in seconds – but we don’t know quite what the ACOs will need.

“One thing we’ve learned, though: when a small peds office puts its data in the hands of a large entity, it’s worth double-checking the results. For more than 20 years, I’ve helped our clients fight insurance companies (which an ACO emulates) and the insurance companies never have the data right. Ever. So if a private peds office can work with us and still be in an ACO, they’ll be able to confirm the accounting.

“Here’s my prediction: As ACOs grow, the practices who participate are going to regret losing control of their data. I’m really going out on a limb there, I know.

What do you think is the greatest challenge being faced by pediatrics when it comes to keeping up with healthcare IT?
“Not getting run over by the Juggernaut.  Everyone else’s demands are put ahead of the pediatricians and the peds usually get served what everyone else is eating.  And it rarely suits them.

“I also tell them all the time: ignore the Meaningful Use money. Completely. And ignore the “deal” that you can get from your local hospital/IPA/etc. Pick the EHR that suits you the most and go with that. All the discounts or federal checks in the world won’t make up for even a 5-percent hit in your productivity or having to spend an extra 10-20 hours a month on charting or IT work. If you do like the local deal, great!  But don’t feel like you have to leap in.”

So there you have it folks. I’d be interested to hear from a pediatrician or two who has gone through or is going through some sort of HIT implementation as a follow-up to these views. Feel free to get in touch with me via the comments section below.

AHIMA Wrap-Up: Domestic vs. International Transcription Still an Issue

Posted on October 19, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

All of the product literature I collected at the recent AHIMA show in Salt Lake City finally arrived in the mail the other day. As I sat sifting through all the pamphlets, brochures, case studies and white papers trying to remember why I had picked them up in the first place, one tag line in particular caught my eye: “Has your transcription seen more continents than you?”

Yes, there were plenty of technologies and services on hand relating to electronic medical records (EMRs) and electronic health records (EHR), depending on which term is your flavor of the week. But what really got my attention was the number of booths I went to that boasted transcription and coding services based right here in the good ole’ US of A, and their competitors that still internationally outsource these types of services.

Most booth reps I spoke with proudly told me that their services were located in the US. On the flip side, one company boasted that all of its services have been totally off-shored in order to meet customer demand for more competitive pricing. So what’s a provider to do?

I am, admittedly, new to the world of coding, and as this was my first AHIMA show, I was unaware of the schism that has developed in the world of domestic and international coding services. But, as a consumer that has been assisted – both competently and disastrously – by call center reps that I’m 99-percent sure were not located in the United States (despite their insistence on being located somewhere “in the Midwest”), I am aware of the consumer backlash that can result from a business’s decision to outsource its customer services.

I can only imagine, however, the pressures providers must feel when they are making decisions along these lines. Do they adhere to what their bottom line indicates is the best choice, which I assume means going international? Or do they stick with US-based companies to ensure that native English-speakers are picking up all the right nuances in documentation?

The brochure featuring the eye-catching tag line above continued its strong messaging with: “You’ve probably heard horror stories about what can happen when transcription services send work overseas. With language barriers, training deficiencies and rapidly changing regulations, mistakes – serious mistakes – are inevitable.”

Really? Inevitable is a pretty strong word. Is it a legitimate one to use in this circumstance?

A white paper from webmedx (now a part of Nuance), “Finance Leaders Rethink Transcription: Six Critical Criteria in a Changing Landscape,” provides a bit more insight into the issue: “Perhaps it was the black market sale of patient information in India …. Perhaps it was the worldwide economic meltdown and loss of U.S. jobs in 2009. Or maybe it is the pressure of tighter HIPAA regulations under ARRA’s HITECH Act. Whatever the cause, the effect is clear. Healthcare providers who sent medical transcription offshore in the past are bringing it back home.”

Are there any providers in the audience who’d care to speak to either side – why they chose to go domestic, or feel that the quality of transcription is just as good abroad? Has “cheap” become overrated?

Chime in with your comments below in answer to my question above.

EHR Incentive Money Congressional Authorization versus Appropriation – Will EHR Incentive Money Disappear?

Posted on July 5, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been having a number of discussions online and through email with people about the future of the EHR incentive money. A number of people are quite concerned with the government funding for the EHR incentive money. You may remember that I posted about this before on multiple occasions and had some really interesting discussion.

Here’s a summary of some of the points that I’ve heard people making when it comes to the EHR incentive money being taken away:

1-There is a crucial difference between the two steps required for Congressional funding, a-authorization and b-appropriations. Congress can authorize, but cannot appropriate for 5 yrs. This applies to the EHR stimulus money. Thus the 5 year EHR payment has been authorized, but no EHR funds have been, nor can they be, appropriated for 5 years, right?

2-There is $18k this year for doctor Medicare EHR. But not the remaining $26k over 5 years has not been apropriated (same applies to hospitals funds).

3-The budget deficit and debt ceiling suggest Congress will be looking now and in the future for cutting every dime they can,
and thus the $20B or so for EHR could be part of the cut. Thus there may be reduced EHR funds, or none, appropriated by Congress after this year.

I still believe in my gut that the EHR incentive money is going to be safe and still around going forward. There’s little benefit to cutting a mere $20 billion from a program that is generally bi-partisan. Plus, no one in congress really knows the potential good or bad impacts of the HITECH act on EHR and healthcare IT. However, it’s really easy for them to quickly assume that more technology in healthcare is good and worth funding (whether the way they’re doing it is good or not…a subject for a different post).

It’s certainly not beyond the realm of possibilities that the government could make some sweeping cuts and the EHR incentive money is a casualty of those sweeping no holds bars type cuts. Point being that I don’t think there are any people in congress that are passionately for it or passionately against it. So, I think that means that it will likely either get carried forward on a whim or cast aside on a whim.

How’s that for a concrete answer? Are there points that I’m missing? Are we misunderstanding the HITECH funding process? Feel free to chime in with any knowledge you might have of the government process.

5 Ways Meaningful Use Will Change Your Practice

Posted on March 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I love the title of this post since it uses the word change. People when they see change start to get really concerned. For some reason we don’t generally like change. We often like it after the fact, but rarely want to engage in change. I’ll be the first to tell you that implementing an EMR requires change. Anyone who tells you otherwise probably has something to sell you. Certainly some EMR require more change than others, but they all require a change.

The American Medical News put out an interesting article discussing what they said would be 5 ways meaningful use will change your practice. Here’s their 5 ways and my commentary on each of the items:

Patients will be more involved in their care – Certainly meaningful use has some requirements that encourage the sharing of clinical information with the patient. I expect in future meaningful use stages we’ll see even more sharing of the clinical information with the patient. However, I don’t really see this sharing as translating to a more involved patient. Tons of people miss incorrect charges on their bank account and credit card statements and they have all that information. I’m sure the same will happen as patients get access to this information. Many won’t care to look and many of those that do look won’t have much of an idea what they’re looking at.

With this said, there is a general movement to the active and involved patient. Combine the easy access to health information (good and bad information I might add), the easy social interactions amongst patients (ie. asking your friends on Facebook), and other changes we see in society and the patients will be more involved going forward. I just don’t see meaningful use being a huge driver for this.

Doctors will find it easier to see how they’re doing – Ummm…this seems way off base to me. First, because it’s pretty hard to define “how they’re doing.” So, it makes it hard to talk about. Let’s just focus on the meaningful use measures. Does anyone really think that tracking the meaningful use measures is going to make a doctor better at what they’re doing? Can they really be used to measure how well a doctor is doing? I guess I just don’t think meaningful use is the right “report card” for doctors.

Physicians will collaborate more with other doctors – Stage 1 definitely does little to help this happen more efficiently. We’ll see if stage 2 or 3 takes it much farther. Although, if stage 3 takes it too far, I imagine many will opt out of showing meaningful use for stage 3 since the payouts are so small at the end of the EHR incentive money.

Long term, having an EMR will facilitate collaboration and information sharing amongst doctors. However, we don’t have the highways for that information built yet.

Physicians will pinpoint practice inefficiencies – This feels a little like the second one to me. However, it’s worth also pointing out that I think it would be a very difficult argument to make that meaningful use somehow makes a practice more efficient. I could certainly make an argument (which I’m sure many would love to argue against) that an EMR can make a clinic more efficient, but not meaningful use.

Physicians will need a firmer grip on data security – MU stage 1 has little HIPAA requirements and I don’t expect MU stage 2 and 3 to change that. There are some privacy and security requirements in the EHR certification that try and take data security and privacy in an EMR to the next level. Also, the HITECH act has provided some “teeth” to the enforcement of HIPAA which it never had before. I still think we need a few more clinics to get “bitten” by it to really understand what the requirements are going to be and how they’re going to enforce it.

Puzzled About Meaningful Use? This Hip-Hop Tune Has The Answers

Posted on March 16, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Spent countless hours worrying over meeting Meaningful Use standards?  Dr. HITECH feels your pain. HITECH, otherwise known as Germantown, MD-based Dr. Ross Martin, MD, MHA, has produced an educational video which offers you the highlights — and we’re serious about this — of Stage 1 Meaningful Use requirements.

As you’ll see, however, Dr. Martin isn’t a conventional lecturer. As Dean of The American College of Informatimuscology, he keeps it real with a hip-hop tune dubbed “The Meaningful Yoose Rap.” (By the way, you’re interested in becoming a fellow of the college, Dr. HITECH invites you to submit musical samples.)

Check out the video and tell us what you think.  Personally, I think a little humor never hurts, even when it comes to a serious topic like MU. But hey, some people just don’t know how to have fun…

Guest Post: The Meaningful Use Clock is Ticking

Posted on March 8, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

John’s Note: Much of this post will be child’s play for those of you reading the blog that are steeped in meaningful use, the HITECH act, EHR Certification, and the EHR stimulus money. However, I thought this guest post was a nice intro to the EHR stimulus money for a doctor or practice manager which was starting to learn. I’m all about helping doctors, so here it is.

90 days of data collection. This is what is required for year one meaningful use. This means by October 1 you better be collecting data…and hopefully you didn’t just start on October 1…that would be playing with fire.

What really is the purpose of Meaningful Use? In the grand scheme of things, the CMS wants to make sure that a practice hasn’t bundled together a spreadsheet and word processor, call it an EHR, and then try to claim a big reimbursement. So, sure, it makes sense that the CMS would have some requirements for your EHR.

As is the situation anytime you try and get money from the government, the list of requirements is lengthy, the red tape is plentiful and the maze continues to get more complex.

So is the case when “proving” meaningful use. Hopefully you aren’t of the idea that buying a Meaningful Use certified EHR makes you a Meaningful User.

Having an EHR with that “certification” stamped on the box is not like an Easy Button.

Selecting that EHR is the first big hurdle you have to conquer…now you have to show you are a Meaningful User.

The items of proof are shown here in this CMS summary [PDF]. What you’ll see is there are 15 Core Objectives you must be able to report on.

That shiny new EHR should have all of these reports built right in. You better try pulling some of those reports to make sure there is some data in them.

So, those 15 mandatory Core Objectives are already selected for you. Next, there are five more you must select from a gallery of ten.

Which objectives should you choose? Wait for it…IT DEPENDS.

Such the non-answer answer.

It does depend on a number of items, but really which five would you choose?

The easiest to gather? DING DING!

Why not?

Why make this craziness any more difficult than it needs to be.

We’ll go over the Menu Set Objectives, and which ones are the easiest for you to pull, in a future article.

John Brewer is the founder of HIPAAaudit.com. He and his team help physicians run HIPAA Compliant practices in the simplest, most pain free way.

When Meaningful Use Isn’t That Meaningful

Posted on March 1, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As you know, I regularly like to highlight some of the best and most interesting comments on my various websites. Especially since I know many of you don’t read all the comments (shame on you). This comment on meaningful use comes from someone who identifies themselves as SoftwareDev and works for an EMR vendor:

Coincidentally, I actually came up with the exact same conclusion [see original post] when reviewing the specs the other day. What I mean is, I identified that the way that we track “problems” in our software serves our customers well, but doesn’t really meet the measurement method of Meaningful Use.

In my app, I can record a “problem” using an ICD-9 code on the patient record (chronic) as well as on the visit (acute/episodic, based on Dx attached to the charges posted for that encounter). I also track descriptive (non-standardized) phrases in our Medical History. The former is good because it meets the standardized terminology requirement, but it fails because I don’t keep a “history” of active, or inactive problems. The latter is good because it is more “all encompassing”, including problems that the patient isn’t actually being seen by this particular doctor for, but also fails because it isn’t recorded by ICD-9 code and descriptor.

Either way, I have to revise the software’s method of recording “problems”, both for historical purposes and for proper coding, and ONLY to meet the Meaningful Use requirement. Not a single customer has ever voiced a request remotely like this to me in my 12 years of handling software in this sector.

Descriptions like this is why I’m concerned about the impact of meaningful use. There’s little doubt that the EHR incentive money has stimulated interest and even purchasing of EMR software. I just wonder what unintended consequences will come from meaningful use and EHR certification. Sadly, the above description may meet meaningful use, but doesn’t sound like meaningful patient care.