Study Casts Doubt on Meaningful Use Accelerating EHR Adoption

The electronic health records meaningful use program has had a negligible effect on physician adoption of EHRs, according to a study published in the Journal of the American Medical Informatics Association.


The electronic health records meaningful use program has had a negligible effect on physician adoption of EHRs, according to a study published in the Journal of the American Medical Informatics Association.

The adoption of any type of EHR system from 2001-2013 “may have increased by as much as 7 percentage points above the level predicted in the absence of MU subsidies,” research authors say, and they conclude that there is weak evidence of the impact of MU on adoption. However, the authors acknowledge that “this estimate lacks statistical significance and becomes smaller or negative under alternative model specifications.”

Study authors found no substantial effects of the MU program for adoption of “basic” EHRs from 2006-2013. These basic EHRs, however, began getting replaced by Stage 1 certified EHRs under HITECH.

Also See: Really? Meaningful Use Did Not Work?

Authors—from the schools of public health at University of Alabama at Birmingham, Indiana University and Johns Hopkins University—note several earlier studies that predicted EHR utilization rates that were done before the HITECH Act was enacted, or based on its imminent enactment. These studies were not consistent with wide ranges in the percentages of providers who would achieve meaningful use. “Therefore, the overall effects of the MU program on physicians’ EHR uptake is unclear compared to normal adoption rate that would have occurred absent the intervention,” study authors say.

In the new study, using 13 years of data from the National Ambulatory Medicare Care Survey (NAMCS) by the Centers for Disease Control and National Center for Health Statistics, authors predict in one model a physician EHR adoption rate in 2017 of around 90 percent, compared to 83 percent that would be predicted in absence of HITECH Act subsidies (payments) to physicians, a seven-point increase in EHR adoption. However, another model finds HITECH contributed insignificantly to EHR adoption—less than one percentage point because of HITECH and a half-percentage point because of the subsidies.

The Centers for Medicare and Medicaid Services issued the following statement defending the meaningful use program:

“To date, the EHR Incentive Programs have paid 471,516 unique providers for adopting, implementing, or upgrading to certified EHR technology or for successfully demonstrating meaningful use of certified EHR technology. We believe this number reflects the positive impact that the program has had on EHR adoption. We look forward to continuing to support providers leveraging health information technology to enhance care coordination and improve patient outcomes.”

The study is available here.

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