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Meaningful Use is breaking hearts
What happens when you fall out of love with an idea?
We’re being somewhat facetious, but to our eyes the question manages to capture the problem with which this early adopter and supporter of EHRs is grappling. For years, he’s been in the front lines of those cheering and charging across the digital frontier. But now he’s not sure.
So what changed? As he puts it, “No, I didn’t stop thinking that EHR was a very powerful tool that could transform care. I didn’t pine for the days of paper charts . . . What changed was my belief that government incentives could make things better. They haven’t. In fact, they’ve made things much worse.”
What follows strikes us as must-reading for policymakers and stakeholders alike. One way of summing up his concerns is to say that he’s become increasingly distressed as he’s watched EHRs go from being one of many tools that can be put to work to help patients, to being, particularly with the demands of Meaningful Use, an end in and of themselves.
In the early days after his practice made the leap from paper to digital, he says, “We didn’t care if we used every part of the product, instead focusing on only using things in a way that improved the care without hurting our office workflow. Early on, we used a hybrid of paper and computers to give us the information in the proper format. Then, once our vendor opened up the product to customization, I totally abandoned the hideous clinical content they had made, designing my own forms that maximized both quality and efficiency.
“But last year, our first year in the ‘meaningful use’ era, our focused changed in a very bad way. We started talking more about our EHR complying to criteria than maximizing quality and efficiency. Our vendor jumped on this bandwagon, ignoring the fact that they were stuck in a pre-internet, office-network design, and instead put all of their resources into letting their users meet ‘meaningful use.’ In the past, the computers were a tool we used to help our patients; with ‘meaningful use’ they became a distraction, taking us away from a clinical focus and driving us toward proper data-gathering.”
That phrase, “taking us away from a clinical focus”, is about the most damning commentary on EHRs that we can imagine, especially since the intent, obviously, is exactly the opposite.
But this is just one doctor’s opinion, so we’re hoping you’ll read his lament in its entirety, and then tell us what you think.
Photo by CarbonNYC via Creative Commons.
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