Last month, during the week of September 10 through September 14 the United States Department of Health and Human Services celebrated Health Information Technology Week. Some considered Tuesday, of that week the highlight as it was designated Meaningful Use Day.
While providers have been awarded hundreds of millions of dollars for implementing phase 1 of “Meaningful Use” by switching over to Electronic Health Records (EHR), not all physicians are celebrating Meaningful Use Phase 2 regulations that were announced by CMS recently.
Physicians Concerned About Phase 2 Meaningful Use
Two issues in particular are making physicians nervous about implementing the phase 2 requirements that go into effect in October of 2014. These concerns stem from the need for the physicians to rely on patient behavior in order to continue to be qualified to continue receiving incentives for EHR. The two components that frustrate doctors the most are:
- Requirements for patient engagement: The stage 2 requirements as published mandate that providers have a summary of care prepared for patients within a stipulated time frame, the part that concerns physicians is that 5 percent of patients will have “to view online, download and transmit” the summary of care in order for doctors to meet the standard. Additionally, another mandate stipulates that patients are able to utilize secure messaging with physician offices. Brian Zimmerman, MD is a strong proponent of EHR and works in the Emergency Department of Miami Valley Hospital in Dayton, Ohio. The facility is part of Miami Valley Hospital, Premier Health Partners. They are a huge health system in southwest Ohio. According to Dr. Zimmerman, medical staffs are concerned that the patient engagement mandates for meaningful use are confounding doctors as they are complicated, may have a detrimental impact on workflow and in the final analysis it is the actions of their patients that will determine if they meet the standard. Zimmerman explains that patient compliance is always dicey and cannot be expected, so the requirement for physicians to have in place a mechanism to guarantee compliance is “really bizarre.” According to Zimmerman:
“It is one thing for physicians to recommend what patients do at home, but to say that 5 percent of to do it? That is tough.”
2. No control over implementation: According to Zimmerman, doctors have enjoyed some benefits of converting to EHR such as ease of ordering test sets, writing prescriptions and greater access to notes on patient records. In addition Zimmerman explained that many physicians feel hospitals are deriving great benefit from the EHR and meaningful use requirements, especially financially while physician workflows “are compromised, potentially hurting their compensation.”
If doctors feel that they are required to add new items to their workdays based upon hospitals want meaningful use incentives without seeing further benefits to their own practices they are going to have possible problems accepting meaningful use. Zimmerman said: When physicians see fewer patients each, which decreases their compensation, it becomes difficult to have a positive viewpoint.”
Zimmerman who is helping to implement EHR throughout the health care system makes good points and his knowledge is first hand from speaking with physicians on staff at his hospital. Further he expects hospitals to be supportive in helping physicians deploy EHR and explain to medical staffs the facility goals relating to EHR. And to also:
- Choose a strong EHR that can be used by physicians too
- Provide streamlined physician training, making it efficient means it will be attended by doctors without grumbling
- Adopt technology; use of automated drop down menus, voice dictation and other technologies to make physician participation productive.
Hospitals need their medical staff to participate fully in EHR deployment if the facility is going to succeed at it. Providing an to easy to use, affordable and technologically advanced system to medical staffs is a good investment for the institutions to make.
Alan E is a freelance writer/editor with a background writing about healthcare issues.