Is the AMA Right in Calling Meaningful Use “Still Broken”?

Feb. 13, 2015
The AMA comes out to decry low eligible-professional attestation rates so far under Stage 2 of meaningful use—but could the use of hyperbolic language end up being counter-productive?

When senior leaders at the American Medical Association issued a public statement reacting to the revelation of low attestation rates among eligible professionals (EPs) so far under Stage 2 of meaningful use, they didn’t hold back.

The AMA’s statement, released on Feb. 11, began thus:

“The American Medical Association (AMA) is alarmed by yesterday’s announcement that more than three quarters of eligible professionals have still been unable to attest to Meaningful Use.”

And then it went on to say this: “The program’s one-size-fits-all approach, that has not been proven to improve quality, has made it difficult for physicians to take part. The penalties physicians are facing as a result of the Meaningful Use program undermine the program’s goals and take valuable resources away from physician practices that could be spent investing in better and additional technologies and moving to alternative models of care that could improve quality and lower costs.”

What’s more, the association asserted that the program’s “one-size-fits-all approach” has actually made it more difficult rather than less, for physicians and other EPs to participate in the meaningful use process.

But if anything, the headline of the statement was perhaps the most accusatory at all, or at least, it seemed to read that way: “AMA: Meaningful Use Is Still Broken.”

And as we all know, the use of the word “broken” in this context is fairly strong language, given that participating in the meaningful use process under the HITECH (Health Information Technology for Economic and Clinical Health) Act is mandatory for most practicing physicians, and for the vast majority of acute-care hospitals, participating in the Medicare program.

And it’s true that the percentage of EPs attesting to meaningful use under Stage 2 is quite small, and could quite justifiably “alarm” healthcare association leaders nationwide. After all, only 15 percent of EPs had attested to Stage 2 by December, in contrast to the 47 percent who had attested to Stage 1.

So… is the use of dramatic language, or even a bit of hyperbole, acceptable, or even desirable, in the context of this process and program, and at this moment in time in the evolution of the U.S. healthcare industry?

I guess this all ends up being an exercise in “glass half-full versus glass half-empty” perception, doesn’t it?

Also, seeing some of the major national healthcare professional associations raise alarms about low rates of attestation can be potentially quite useful. But there is a question of intent. Could the AMA’s actions actually encourage more physicians and other EPs to attest to Stage 2 of MU? Or is the AMA really hoping to dismantle the entire program, or at least to add to the chorus of voices demanding that no reimbursement penalties be attached to the conclusion of the meaningful use program?

It would take congressional action for all or even most financial penalties to be removed, given that such penalties are embedded in the HITECH Act legislation itself. And the fact is, senior officials at ONC, CMS (the Centers for Medicare and Medicaid Services) and HHS (the Department of Health and Human Services) are in an extremely tricky and delicate position right now as it is, as they try to encourage EPs (and hospital-based organizations) forward to fulfill the obligations set out under HITECH for digitization and clinical IT implementation.

But the jury is out as to whether the use of language like “still broken” with regard to the meaningful use process will be helpful or harmful in the long run. And everyone already knows that the AMA was opposed to much of HITECH from the start.

So we’ll have to see how all this plays out. But one could legitimately argue that engaging in the use of hyperbolic language, and embedding such language in the headlines of public statements, could actually be counter-productive in terms of encouraging clinical professionals to move forward to do what on a broad level really is the right set of things to do; unless, of course, that is the intent of the use of such language.

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