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EMRs and "Meaningful Use."

Health care providers showing "meaningful EMR use" by 2011 are eligible for incentive payments from the $20 billion EMR stimulus package. Writing in netdoc.com, Patricia King, JD outlines the details for physicians:
"To be a "meaningful EHR user", the physician must satisfy three criteria:

* The physician must use "certified EHR technology" in a meaningful manner, including electronic prescribing.
* The physician must demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.
* The physician must submit information on clinical quality measures specified by HHS.

HHS will designate the way in which a physician is recognized as a meaningful user (through attestation, submission of claims with codes indicating that a patient encounter was documented using certified EHR technology, survey responses, submission of quality reports, or other means)."
I know this is HHS's ball game and they're entitled to make the rules. Play by their rules, buy an approved system, use it for e-prescribing and care coordination, report the right data in the correct format and the incentives rain down, I guess.

Hopefully, somewhere in all those indicators, are measures of the direct benefit to those same consumers from the EMR investments being encouraged on their behalf. I get that e-prescribing and coordinating care are wonderful things to do, and certainly agree that more - and better - quality reporting is long overdue.

Typical, though, of an inward-focused industry, the direct benefits to consumers are more implied than obvious, at least so far. OK, EMRs will facilitate more e-prescribing. Great. And more e-prescribing will lead to...what? What's all the fuss wrapping up to? What's in it for me as consumer and patient? Maybe THAT ultimate outcome is what Medicare ought to be incenting.

It seems to me that the road-map to "meaningful use" in the purest sense begins with a desired consumer benefit and then drives the technical issues and processes to achieve that benefit. I'm sure I'll get a comment or two referencing research proving the merits of e-prescribing (improved health, better medication compliance, fewer errors, etc.) Fine, incent the ultimate delivery of those benefits, not the process's mere presence or absence.

The takeaway: Incent benefits and outcomes, not processes. Or as I always say: effort is appreciated. Results are required.


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