Healthcare Is Yet To Capitalize On Meaningful Use

The Medicare and Medicaid EHR Incentive Programs offer financial incentives for meaningful use of certified EHR technology to raise patient care. To get an EHR incentive payment, providers need to prove that they're meaningfully using their EHRs through fulfilling thresholds for a variety of goals. CMS has built the goals for “meaningful use” which eligible professionals, suitable hospitals, and critical access hospitals (CAHs) need to meet in order to have an incentive pay out. Dale Sanders, vice president for strategy at Health Catalyst stated in a post that, the program developed a very complex system which could go through the test of MU, but not generating meaningful outcomes for patients and clinicians. He mentioned that it's time to end the government MU program, get rid of the expensive administrative overhead of MU, get rid of the government subsidies which also produce perverse incentives, and allow 'survival of the fittest' play a greater part in the process. Sanders further stated that meaningful use Stage 1 created a false market for mediocre products.

It was discovered by the researchers of Mathematica Policy Research, there had been a "significant" rise in the percentage by 17.4% to 36.8% of hospitals getting incentive payments for obtaining Meaningful Use during 2011 and 2012. As per the research, the smaller and critical reach hospitals had been especially weak in falling behind in Meaningful Use of EHRs because of their lower patient volume, insufficient resources to get EHRs, difficulty in hiring certified IT people and getting a appropriate EHR vendor. Based on the CMS data, by March 2014, over 371,000 health care providers have received $22.9 billion on meaningful use incentive payments in taking part in the madicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The data additionally reveals, above 470,000 eligible professionals, eligible hospitals, and also critical access hospitals are currently registered for the Medicare and Medicaid EHR Incentive Programs since March 2014.

In a recent research released in JAMA Internal Medicine , it seems to be “no association” between being a “meaningful user” of EHRs and also the quality of care offered to patients, even though one of the primary objectives of the Meaningful Use program should raise the quality of care. The researchers learned dealing with adult outpatients at Brigham and Women's Hospital and affiliated ambulatory methods during a 90-day reporting duration in the year 2012 to evaluate if there had been quality progress on seven measures for 5 chronic diseases: hypertension, diabetes mellitus, coronary artery disease, asthma, and depression. All the doctors taken the same advanced EHR. Based on a research published in last summer in Health Affairs, Meaningful Use attestation continues to be inconsistent with small and much remote hospitals are having a hard time to fulfill the incentive program's needed thresholds. During the 2014 HIMSS Annual Conference & Exhibition in Orlando, Florida, an opinion poll was conducted by Stoltenberg Consulting. It was discovered that 70% of participants don't believe their organizations are making the most of meaningful use.

Shane Pilcher, vice president, Stoltenberg Consulting, stated in a press conference, although many organizations might see meaningful use like an ought-to-do regulatory, but it happens to be a lot more, organizations have to see meaningful use like a strategy, discipline and procedure that helps healthcare transformation and helps reduce changes to initiatives like complete patient engagement value-based responsible care and population health management. Lots of officials have mentioned that MU Stage 1 is only the start, targeted to move hospitals and doctors to adopt these systems, and MU Stage 2 includes clinical quality enhancements. But Meaningful Use Stage 3 is exactly what lots of officials think will definitely pack the punch in the interest of enhancing clinical outcomes. Furthermore, a study revealed, MU Stage 2, what improves the thresholds many of the quality measures, has simply kicked off, and Meaningful Use Stage 3 is not ready to go live before 2017.

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Changes in approach needed for mHealth implementation

In order to truly become a disruptor in the healthcare industry, mHealth needs to break out of the shackles restricting its widespread use. Although the area shows a lot of promise to bring about major changes in healthcare delivery, the slow pace of its adoption has resulted in many industry leaders quoting the benefits to be speculative. They are generally the elderly lots who have throughout their careers seen various such disruptions start, show a lot of promise and then frizzle away. They are waiting for this one to stand the test of time and meet the changing requirements of the industry. There are enough indications already to suggest that mHealth has the elements to change the healthcare delivery on its head and transform it completely. Infact mHealth is the result of unsustainability of current healthcare spending, rapid growth of wireless connectivity, and the need for more precise and individualized medicine.

So the pertinent question which comes to mind is that if certain obstacles have resulted in the emergence of a solution, what has stopped its widespread use? In order to achieve the purpose, some roadblocks have been identified. They are as follows:

• Complexities which exist in the healthcare system related to current drivers of reimbursement
• Apprehensions of the part of clinicians as they expect the patient-physician relationship to weaken further; with a likelihood of an increase in their workload
• Challenges to the appropriate use and validation of mHealth technologies
• Possibility of downloading apps which are not very useful and can possibly even have a detrimental effect if used

mHealth intends to transform healthcare by addressing inefficient practices and various challenges faced by clinicians and consumers. The real beginning of the mHealth surge will start the day Physicians stop being wary of recommending apps. And for that to happen, there needs to be more availability of evidence. It is only by doing a systematic research on the impact of mobile technologies on health outcomes and showing positive results, on a continuous basis, that reliable evidence can be gathered. Also, for its widespread usage and subsequent acceptance, partnerships with governments become a critical factor. The key here is to identify and engage very early, by identifying the right people within the setups to provide support and handing them over to scale up after reaching a certain level of success. Achieving scale without such an approach i.e. involvement on the part of the government, is next to impossible.

Before beginning any mHealth project, it is very important to take into account 4 dimensions - People, places, payment and purpose. Importance of considering these factors is highly critical in determining the outcome. The following needs to be taken into account while addressing the dimensions

• People: Technological platforms to be used have to be chosen keeping in mind the demographics and preferences of the consumers and health professionals who are likely to use them. A platform with exceptional features and lacking on usability is of no use.
• Places: There is a need to have a strong backbone of network with good accessibility and reliability. This has a major bearing on how and when mHealth is used. If the functionalities available are complex, then in order to leverage those, the required download speed and bandwidth capacity needs has to be available as well.
• Payment: Evidence-based standards should be used to link payment with quality outcomes. Additionally, organizations dealing with patient data should adhere to the required policies to address privacy and security.
• Purpose: In order to be effective the strategy should be such as to align with complexities involved in case management and various clinical objectives.

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