Docs contemplate meaning
Industry pushes meaningful use through incentives
lmost everyone in the healthcare industry, it seems, wants physicians to get on the meaningful-use bandwagon. The question is whether most physicians are ready to jump onboard.
Payers as well as provider and licensure organizations recently made a giant push to encourage physicians to adopt electronic health records, announcing several health information technology initiatives at a forum held recently in Washington.
“This is a team sport,” said David Blumenthal, national coordinator for health IT, during the forum, which was sponsored by Health Affairs and Brandeis University’s Health Industry Forum. To advance the CMS’ new meaningful-use regulations, “it’s clear that the sustainability of this effort … has to come from the private sector,” Blumenthal said.
UnitedHealth Group, for example, is deploying on a national scale its performancebased contracting program, which provides outcomes-based financial incentives to physicians who use EHRs in ways that meet meaningful-use criteria. And ThedaCare, a system of three hospitals based in Appleton, Wis., plans to train all of its physicians on the meaningful use of health IT through extensive
Atraining of its employed physicians and independent community physicians. Physicians will also be feeling the pressure to be IT savvy in order to maintain their professional certification. The American Board of Medical Specialties said that it would incorporate tools to promote meaningful use of health IT into its maintenance-of-certification program.
More than 750,000 U.S. physicians are certified by an ABMS member board, “so it’s readily apparent” that building meaningful use of health IT into certification maintenance will benefit patients, ABMS President and CEO Kevin Weiss, said in a written statement. Additionally, the merging of these two tools “will help to facilitate physicians’ knowledge, skill and use of health IT, and in turn can improve physician performance and patient outcomes,” he said.
In particular, the ABMS wants to develop new knowledge self-assessment modules that among other things would evaluate a physician’s knowledge of health IT for incorporating evidence-based medicine into their practice, decision support and data acquisition, and analysis and reporting related to correct use of the technology. The licen- sure board is also interested in data interchange utilities that would enable physicians to submit Physician Reporting Quality Initiative and health IT meaningful-use measures to the boards in the same format used by the CMS in an effort to avoid redundant data submissions.
Representatives of licensure organizations stress that the new health IT tools would not be required of doctors to stay certified. But some doctors are wary of this pairing of maintenance of certification and meaningful use.
“I don’t believe achieving meaningful use equates to maintenance of certification,” said Michael Migliori, an ophthalmologist in Providence, R.I. Maintenance of certification is a measurement of clinical knowledge, whereas meaningful use is a clerical designation, he said.
“I understand the clinical importance of electronic medical records both in terms of patient safety and quality, but we are not at the point where EMR and health information exchange are ready for universal implementation,” Migliori said. “They should not be linked at this time.”
The intent of these initiatives is laudable, but “the devil is in the details” on how this will all play out in the long run, said Lori Heim, president of the American Academy of Family Physicians. It’s unknown at this point whether the ABMS’ new health IT provisions to maintain certification “will remain simply a tool or a requirement,” she said.
“We certainly support health IT adoption, but it has to work within physician practices” and not be imposed upon family physicians, she said.
Migliori: “They should not be linked at this time.”