Meaningful Use Has Larger Issues than Certification

A recent public hearing was designed to get industry feedback on how the electronic health records certification process can be improved. What the HIT Policy Committee workgroup also received was an ear full from those fed up with the number and pace of meaningful use requirements.


A recent public hearing was designed to get industry feedback on how the electronic health records certification process can be improved. What the HIT Policy Committee workgroup also received was an ear full from those fed up with the number and pace of meaningful use requirements.

Sarah Corley, M.D., chief medical officer for NextGen Healthcare, testified at the May 7 hearing as part of a vendor panel. "A lot of what you heard in the testimony was not related just to the certification process--which certainly has room for improvement--but a lot of what you heard was related to meaningful use requirements," Corley told Health Data Management. "While [ONC Federal Policy Division Director] Steve Posnack was trying to point out that the two are separate, to people that use the software they're the same because they can't separate them."

Alisa Ray, executive director of the Certification Commission for Health Information Technology, similarly testified before the HIT Policy Committee workgroup about the tremendous burden of the meaningful use program on providers and vendors alike.

"The federal government is eager for adoption to occur as rapidly as possible. Today, however, we hear from all stakeholders that adequate time for implementation is the biggest challenge," said Ray. "Providers need more time to successfully implement a new or upgraded EHR, more time to gather data and more time to prepare reports. Vendors need more time to program their systems to new requirements once the final requirements and test methods are locked down."

The American Medical Association in a public comment sharply criticized the workgroup for being "unwilling to make a recommendation on making the overall program more manageable for physicians." Mari Savickis, AMA's assistant director for federal affairs, acknowledged that the focus of the hearing was on EHR certification but argued that it "cannot be divorced" from meaningful use. 

According to Savickis, about 40 percent of eligible professionals have never participated in the meaningful use program and, of the 60 percent that have, 20 percent have dropped out. "The way to keep physicians from dropping out today or keeping them from making a decision to not participate is to make the program criteria more flexible," she said.

AMA is urging ONC and CMS to allow physicians who meet 75 percent of the requirements to obtain an incentive and those who meet 50 percent of requirements to avoid a penalty.     

"We fear that unless we change the course we are headed that we're going to create a parallel market--the one where providers participate in meaningful use with certified systems and those who peel off and seek higher performing systems,” said Savickis. “This cannot possibly be good for the long term goal of data exchange and getting patients more connected."

"All the testing in the world will not ensure the meaningful use program provides value to physicians and patients," she warned. "Only flexibility in the program now will provide the much needed relief to the end user--the physician--who these programs are negatively affecting."