MU2: Too Far, Too Fast?

MU2: Too Far, Too Fast?

As practices are beginning to really look at the metrics to meet Meaningful Use 2 requirements, many are saying to themselves, is this really worth it?  Meaningful Use Stage 1 was all about getting critical masses of physicians to start collecting data in their EHR. The change was enormous for many practices. Some are not yet recovered from the impact it had on workflows and many are struggling to optimize their adoption. Practices who had little personal investment in the success of their implementation are paying for it every day.

Others have really begun to see the power in their practice transformation. Having access to information at your fingertips, even remotely, can change medical decision making and improve patient care. Realizing how you can use that information to see how your patients as a whole are being cared for, identifying gaps and instituting quality improvement projects empowers you to institute change that matters. I just had a conversation last week with a practice who made huge improvements in getting their adolescents recalled for annual well visits and completing HPV series on time. The patients got better care and they improved their bottom line both with visit income and higher pay for performance incentives.

One of the problems with the Meaningful Use program is the rigidity of prescriptive use of technology. They have defined what matters to receive funding, and in some cases it isn’t what matters to practices. The bigger problem is that MU Stage 2 raises the bar on the thresholds that need to be achieved in areas that are in large part, beyond the control of the practice.


Let’s take a closer look at some of those raised thresholds:
  • Use CPOE for more than 60% of medications, 30% of laboratory and 30% of radiology orders
  • Record smoking status for more than 80% of patients 13 years and up
  • Incorporate lab results as discrete data for more than 55% of orders
  • Document demographics and vital signs for more than 80% of patients


Add on top of this some aspects that are not entirely within practice control, but need to be achieved:
  • More than 5% of patients must send secure messages to their provider
  • Eligible Providers (EPs) must provide summary of care document for more than 50% of transitions of care and referrals, with 10% sent electronically
  • Practices provide online access to health information for more than 50% of patients, with more than 5% actually accessing the data


What does a practice do if they don’t have any specialists who will receive their summary of care document from their EHR? What about practices whose patient population that doesn’t see the value of a patient portal or have access? How do you make patients send you a message?

Is all this extra work worth $8,500 per provider? Will it cost more than this extra money to implement the changes to your workflow? Could you make the same $8,500 in a way that is more important to you, perhaps seeing 2 extra well visits per week? While Medicare has been driving the meaningful use requirements in adult medicine, pediatricians have a choice to make. Will we go along and do as they expect? Or will some of us choose to use the technology we have implemented in a way that will really make a difference for our practices and our patients? Who’s driving your EHR?