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Monday, May 12, 2014

The future of Meaningful Use?

Thrill is gone as meaningful use strains
'I’m telling you, it’s really, really hard out here.'
Dana Manos, WASHINGTON | May 9, 2014

It seems just about everybody has a gripe or two concerning the meaningful use program: software vendors that make electronic health records systems, hospital CIOs, the very people charting the related committees and, of course, physicians.

Whether that means it’s time to trim the EHR program’s sails, turn the boat around, or abandon ship entirely is becoming a matter of increasingly winded debate...

Is meaningful use driving eligible providers off course?
Kyle Murphy, PhD,  May 12, 2014

The concept of meaningful use has many supporters. Its execution, however, has its fair share of detractors. Even the most ardent proponents of meaningful use recognize the deficiencies present in the certified EHR technology required by the EHR Incentive Programs...

Meaningful use involves a big amount of money: billions in incentives to eligible providers, more so to the EHR vendors whose systems they had adopted. As the industry shifts toward a value-based approach to care delivery, patients will more and more assume the role of consumers which in turn will require providers to be more discriminating in how they treat their customers.

“If reimbursement is going down, we have to always vet our decisions about how they provide value and we can recover that cost. There’s a very serious value proposition we’re having to make, and that’s good. It should be that way — we should be good stewards anyway,” says Reid.

Meaningful use is only in its second phase, but early results from Stage 2 are underwhelming. Could it be the case for providers that the meaningful use journey is already.

4 hospitals, 50 EPs have attested to Stage 2 Meaningful Use
Jennifer Bresnick, May 7, 2014

Only four eligible hospitals (EHs) and fifty eligible providers (EPs) have attested to Stage 2 of Meaningful Use so far, said Beth Myers on behalf of CMS during the latest Health IT Policy Committee meeting this week.  While Myers stressed that the “slim amount of data” is too little to form an opinion about the success of Stage 2 so far, she was optimistic about the outlook for the second stage of the EHR Incentive Programs despite ONC Acting Director, Office of Economic Analysis, Evaluation, and Modeling, Jennifer King, noting that small rural and critical access hospitals (CAHs) are significantly lagging behind their peers in adopting EHR technologies ready for the new challenges ahead...
I have never really liked the phrase "Meaningful Use." Too easy to mock. Meaningful to whom? The clinicians who have to use the technology, or the payers and policy wonks?

We need Effective Use of health IT by those who must use it. That assertion implies a ton, obviously, and it goes way beyond capturing a relative handful of measures in "structured data" formats.

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Oh, yeah, btw...
EHR Hardship Exception Deadline Is July 1
By Christine Kern

CMS provides update on EHR Hardship exceptions for eligible professionals who haven’t applied yet.

Those eligible professionals within the Medicare EHR Incentive Program who did not successfully meet meaningful use in 2013 may still submit a hardship exception application for payment year 2015, according to the Centers for Medicare and Medicaid Services.

As HealthData Management reports, the CMS deadline for eligible professionals to apply for 2013 reporting year-2015 payment adjustment year hardship exceptions is July 1. To date, 600 eligible professionals have applied for hardship exceptions, according to a CMS official who made a presentation during the Health IT Policy Committee's May 6 meeting.

Elisabeth Myers, policy and outreach lead for the CMS Office of E-Health Standards and Services, told the committee that "We have received a number of hardship exemption applications. I know that that's been a big question of how those are going."

Acceptable conditions for applying for the hardship exemptions include EHR vendor issues, lack of infrastructure and unforeseen/uncontrollable circumstances, "lack of control over the availability of Certified EHR Technology" and "lack of Face-to-Face Interaction." Hardship exceptions are valid for one payment year only; new applications must be submitted each year to continue a hardship exception claim for the following payment year...
See the relevant CMS site here.
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UPDATE

From NBC News. Who owns your health data?

 

I posted on health data ownership back in 2011. Here as well.

apropos...
Hospitals overcharge med records by $7M
Lawsuit alleges three New York hospitals and business associate overcharging up to $0.50 per page

Erin McCann, May 5, 2014


A triad of big name hospitals have come under fire recently for allegedly overcharging patients for copies of their medical records.

Back in March, New York-based Mount Sinai Hospital, Montefiore Medical Group, Beth Israel Medical Center and release of information service company HealthPort Technologies were slapped with a class action lawsuit for reportedly violating New York State's public health law regarding medical record request fees.

The group of plaintiffs representing some 100 members alleged the three hospitals and HealthPort Technologies, the company responsible for handling the record requests, overcharged patients and clients by up to $0.50 per page. New York Public Health Law stipulates fees for medical records are not to exceed $0.75 per page and that fees are not to exceed the actual costs incurred by the provider.

[See also: Charging for data: What is too much?]

According to the lawsuit, clients were charged around $0.75 per page when the incurred costs only calculated to $0.25 per page...
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More to come...

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