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Tuesday, August 11, 2015

Meaningful Use: the 30 billion dollar flush?

From FierceEMR:
Meaningful Use impact on physician EHR adoption 'weak'

The Meaningful Use program and its incentive payments lack "statistical significance" on physicians' adoption rates of electronic health records, according to a study in the Journal of the American Medical Informatics Association (JAMIA).

The researchers, from the University of Alabama at Birmingham's School of Public Health and elsewhere, assessed the impact of the Meaningful Use program on EHR uptake by examining adoption by nonfederal office-based physicians, excluding radiologists, anesthesiologists and pathologists. They used a diffusion model of new products to examine the shape of the diffusion curve to plot sales or share of potential market...
Impact of the HITECH act on physicians’ adoption of electronic health records

Background and Objective The Health Information Technology for Economic and Clinical Health (HITECH) Act has distributed billions of dollars to physicians as incentives for adopting certified electronic health records (EHRs) through the meaningful use (MU) program ultimately aimed at improving healthcare outcomes. The authors examine the extent to which the MU program impacted the EHR adoption curve that existed prior to the Act.

Methods Bass and Gamma Shifted Gompertz (G/SG) diffusion models of the adoption of “Any” and “Basic” EHR systems in physicians’ offices using consistent data series covering 2001–2013 and 2006–2013, respectively, are estimated to determine if adoption was stimulated during either a PrePay (2009–2010) period of subsidy anticipation or a PostPay (2011–2013) period when payments were actually made.

Adoption of Any EHR system may have increased by as much as 7 percentage points above the level predicted in the absence of the MU subsidies. This estimate, however, lacks statistical significance and becomes smaller or negative under alternative model specifications. No substantial effects are found for Basic systems. The models suggest that adoption was largely driven by “imitation” effects (q-coefficient) as physicians mimic their peers’ technology use or respond to mandates. Small and often insignificant “innovation” effects (p-coefficient) are found suggesting little enthusiasm by physicians who are leaders in technology adoption.

Conclusion The authors find weak evidence of the impact of the MU program on EHR uptake. This is consistent with reports that many current EHR systems reduce physician productivity, lack data sharing capabilities, and need to incorporate other key interoperability features (e.g., application program interfaces).
The paper is paywalled, so I can't get at all of it.


From the source article:
The study's authors likened the Meaningful Use program to the "cash for clunkers" subsidies in the car industry, in that the Meaningful Use payments may have only contributed to "inevitable" adoption of EHRs. In fact, the program may have had negative unintended consequences, such as stifling technological innovation in favor of meeting "certified" technology.
Yeah. My irascible concern all along over at Clinic Monkey. Be interesting to see what upshot ensues in Congress -- if any.

Meaningful use of EHRs by doctors fell in 2014
By Joseph Conn  | August 12, 2015

Participation by office-based physicians in the electronic health-record incentive payment program waned significantly in 2014, the program's fourth year, as clinicians faced system upgrades and tougher requirements.

The number of physicians and other eligible professionals in ambulatory care who attested to having met the requirements of the multibillion-dollar federal program dropped by 12% last year compared with 2013 numbers, based on federal data for the type of EHR system these providers most commonly use.

Meanwhile, less than a third of the office-based providers using complete EHRs managed to step up to the program's more stringent Stage 2 requirements in 2014...

More to come...

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