Since the Electronic Health Records (EHR) incentive program known as Meaningful Use began in 2011, the healthcare community has felt its impact and attempted to meet the increasing obligations. A new language has been created with an alphabet soup of acronyms. Physicians voice concerns that complying with Meaningful Use competes with attention on patients and slows productivity in the office. Hundreds of vendors exist and create confusion even before the purchase of a system. After implementation there tends to be a learning curve that drains precious time.

Providers in the United States are in various stages of Meaningful Use and a recent survey shows that the number of physicians adopting an EHR is leveling off.  Most physicians state they will be able to meet obligations of compliance with Stage 3 of Meaningful Use when it becomes mandatory in 2018. However, many do not hold a favorable view about the program.

 

Source: Proposed Rule by CMS Fed Register 3/30/2015

 

Keeping a positive outlook might be easier if we remember the original intent of the program. According to the official HealthcareIT.gov site, Meaningful Use is using certified (EHR) technology to:

1. Improve quality, safety, efficiency, and reduce health disparities
2. Engage patients and family
3. Improve care coordination, and population and public health
4. Maintain privacy and security of patient health information

Ultimately, it is hoped that the meaningful use compliance will result in:

• Better clinical outcomes
• Improved population health outcomes
• Increased transparency and efficiency
• Empowered individuals
• More robust research data on health system

https://www.healthit.gov/topic/meaningful-use-and-macra/promoting-interoperability

It would be wonderful to achieve the ultimate goal of better clinical outcomes within our health system, but in the meantime meeting the required objectives can be complicated. An example of an objective that continues to change is Computerized Provider Order Entry (CPOE). Stage 2 expanded CPOE so that it also applies to laboratory and radiology orders as well as medication orders.

On March 30, 2015, the proposed rule for Meaningful Use Stage 3 was published in the Federal Register http://federalregister.gov/a/2015-06685
The proposed rule maintains the objective of CPOE with the intent to “reduce errors and maximize efficiencies” and continues to extend its reach. The proposed rule expands CPOE to include diagnostic imaging as a broad category that includes ultrasound, magnetic resonance and computed tomography.

The proposed rule includes the Stage 2 policy that requires orders to be entered by a licensed healthcare professional to count toward this objective. The order must be entered by a qualified individual or entered by an individual under direct supervision of a qualified professional due to impact on patient safety. A layperson is deemed unqualified to perform these tasks.

The CPOE objective is just one example of continued expansion of the Meaningful Use provisions in an effort to protect patients and improve outcomes. Regardless of their feelings on the EHR incentive program and its complications, providers will strive to meet the necessary objectives of Stage 3 while keeping focus on the most important aspect of their jobs- patient care.