A few weeks ago, Jews such as yours truly celebrated the holiday of Purim (OK, I didn’t actually celebrate because I don’t have kids but that’s beside the point). The holiday is basically the Jewish version of Halloween, which some Jews don’t celebrate because it has a Pagan background.
Of course, Purim is a lot more complex than “Jewish Halloween,” even though most temples will invite little kids to dress up and give out candy. There’s a back story associated with it. I’ll spare you the details but one of the key characters of the Purim story is a guy named Haman. He is the antagonist of the story because he tried to kill all the Jews.
I recently thought of Haman, not only because Purim was a few weeks ago, but because of a survey we at Healthcare Informatics created on meaningful use. When the story of Purim is retold, little kids are encouraged to “blot” out Haman’s name. This is done through booing, hissing, or using noisemakers. Haman’s evil and the point is that his name doesn’t really deserve to be said out loud.
When the story of technology in healthcare is retold years from now, it’s very possible that doctors will blot out the words “meaningful use” the same way little kids blot out Haman. The survey, conducted by QuantiaMD, the Waltham, Mass.-based social network for physicians, was a reaction from doctor community on the proposed rule for Stage 3 of meaningful use.
Let me summarize the physicians’ thoughts on the proposed rule for Stage 3 of meaningful use as succinctly as I can: Not pleased.
QuantiaMD surveyed 150 physicians in its network about the recently proposed rule from the Centers for Medicare and Medicaid Services (CMS), which will establish a single set of objectives and measure, tailored to eligible providers (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs). This will be optional for providers in 2017 and required by 2018, regardless of a provider's prior participation in the Electronic Health Record (EHR) Incentive Program.
When it came to this measure and other provisions, physicians overwhelmingly (61 percent) said the said the government did an unfair job with the Stage 3 proposed rule. This, despite the fact, that most (71 percent) say they’ll be able to catch up by 2018. The majority of physicians said the patient engagement and coordination of care measures would be the toughest to meet.
Those simple survey statistics didn’t tell the tale of how annoyed and irked many of these physicians are with meaningful use and various specific measures. No, that became obvious when we read the answers to our open-ended question: What would you make different about the proposed rule?
A ton of people answered that question by saying “everything” and that CMS should abolish the program entirely. Some were even harsher than that. “It all stinks.” “It’s a waste of time.” One doctor even let some expletives fly.
As I blogged a few weeks back, there seems to be a lot of consensus that the meaningful use program needs major reworking. Nothing about the Stage 3 proposed rule changed the minds of the majority of physicians, who are probably the harshest critics of the program.
I am sure many of you health IT enthusiasts are saying the obvious: They probably didn’t even look at the Stage 3 proposed rule before filling out this survey. I’m sure for some that’s true. Some even admitted as much in the open-ended answers. Others probably had only looked at a snapshot of the objectives and I’m sure a few even had a better understanding than that.
The point is that it doesn’t matter. There could be a measure in there that would give them free Netflix for a year and they’d still probably hate it. Physicians are booing, hissing, and using noisemakers at the very mention of meaningful use. That’s where we’re at.
We often write about physician engagement at Healthcare Informatics. Successful IT leaders talk about bringing physician leaders on board at the start of a major implementation. Without that engagement, many projects die on the vine.
Meaningful use isn’t dying on the vine. It’s been around for a while and has led to a significant uptick in the adoption of EHRs. However, the final stages of the program—which you could argue are the most significant because of the need for interoperable systems—face a significant roadblock in flourishing further. They face the reality that for most physicians, meaningful use is the villain. That’s a problem.
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