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Monday, July 22, 2013

"20%" MU dropout rate? "17% dropout rate"?
"To clearly address the meaningful use dropout rate and ensure the ongoing success of meaningful use, the government must reduce the program’s complexity.

My last EMR Straight Talk post, which addressed the alarming 17% meaningful use dropout rate, generated many comments and resulted in several subsequent media interviews. While CMS has acknowledged the facts regarding this program failure, it does not acknowledge the gravity of the implications for the future of the program. According to a Bloomberg News article, CMS attributes the fallout to many of the same reasons that I have identified from the outset—program complexity, lack of fit with specialty practices, cost, dissatisfaction with EHRs, and inability to meet the meaningful use requirements...
"...[P]hysicians have been quite outspoken about their concerns from the beginning, expressing their perception of the program as overly burdensome, wasteful, and distracting from their mission to provide that care. Now, the evidence is in—they are not just speaking, but they are walking. Clearly, to ensure the ongoing success of meaningful use, the government must fundamentally reduce the program’s complexity.

Recall from my July 8th post "Whither/Wither Meaningful Use."
Meaningful Use program loses 20% of attesting docs
July 8, 2013 | By Marla Durben Hirsch

The dropout rate for Meaningful Use has "soared" in the second year of the program, with a whopping 21 percent of family physicians who attested in 2011 failing to do so in 2012, according to a recent article in AAFP News Now, a publication of the American Academy of Family Physicians.

AAFP reports that in reviewing Centers for Medicare & Medicaid Services attestation statistics, 23,636 family physicians became first-time attesters in 2012, a 180 percent increase from 2011. But of the 11,578 family physicians who attested in 2011, only 9,188 stuck with the program and attested in 2012.

The overall dropout rate among all physician specialties was 20 percent...
Oh, well. What's a ~18% relative reporting disparity among friends?

The Holy EHR Wars.
...A few years ago ... there were dozens of EMR vendors trying to sell software to physicians and hospitals, and like every vendor of any product, they were actively and creatively marketing their wares. Save time and money was a common marketing slogan. EMR websites were sporting all sorts of fancy calculators comparing the costs of doing business on paper to doing business on a computer. The costs of new charts, dividers, paper, ink cartridges, each chart pull, forms, printing paper, etc. were carefully added and compared to the almost zero cost of using software instead. Some fancier calculators even factored in the rent for the additional space needed for chart racks. There were estimates of the number of FTEs that could be let go, or used for worthier causes, and the number of additional patients you can see, if you just buy this or that EMR. Some vendors went as far as advertising better care for patients, with advanced features like automated lab results, pre-built clinical templates and clinical decision support. Folks were kicking tires, shopping around and buying when convinced by ads, sales guys and gals, or even a special discount for the month of August. It was a market, like selling beer, or cars.

But then something strange happened. The United States Government became a believer in the EMR vendors’ marketing slogans. Health care was expensive and not as good or as accessible as it could be, and the EMR vendors promise of saving time and money while providing better care was the perfect solution, particularly since nobody else had anything to offer. Thus the Promise of Technology was born with a silver spoon in its mouth, and was immediately and extensively showered with millions and billions of incentives and resources. The messages on EMR vendors’ websites changed practically overnight from preaching to the infidels to preaching to the choir. Get your incentives, guaranteed, or your money back, was the new slogan. It wasn’t like selling beer anymore. It became missionary work. And, like all great mythological promises, the religion based on the Promise of Technology developed its high-priests, prophets, masses of passive followers, skeptics, and blasphemous heathens destined for martyrdom. The Holy Wars are now in full swing...



Tomorrow. I'm going to try to watch it live.

More to come...

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