Meaningful use’s benefits and burdens for US family physicians

Author:

Holman G Talley12,Waldren Steven E3,Beasley John W45,Cohen Deborah J6,Dardick Lawrence D7,Fox Chester H8,Marquard Jenna9,Mullins Ryan10,North Charles Q11,Rafalski Matt12,Rivera A Joy13,Wetterneck Tosha B1415

Affiliation:

1. Center for Ergonomics, University of Louisville, Louisville, KY, USA

2. Department of Industrial Engineering, University of Louisville, Louisville, KY, USA

3. Alliance for eHealth Innovation, American Academy of Family Physicians, Leawood, KS, USA

4. Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

5. Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA

6. Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA

7. UCLA Health – Santa Monica Bay Physicians, University of California, Los Angeles, CA, USA

8. Department of Family Medicine and Department of Biomedical Informatics, University of Buffalo, Buffalo, NY, USA

9. Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, MA, USA

10. Cerner Corporation, Kansas City, KS, USA

11. Ambulatory Services and Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA

12. Heart of Texas Community Health Center, Waco, TX, USA

13. Knowledge and Systems Architect Team and Information Management Services, Children’s Hospital of Wisconsin, Milwaukee, WI, USA

14. Department of Medicine and Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

15. Department of Industrial and Systems Engineering, and Center for Quality and Productivity Improvement, University of Wisconsin, Madison, WI, USA

Abstract

Abstract Objective The federal meaningful use (MU) program was aimed at improving adoption and use of electronic health records, but practicing physicians have criticized it. This study was aimed at quantifying the benefits (ie, usefulness) and burdens (ie, workload) of the MU program for practicing family physicians. Materials and Methods An interdisciplinary national panel of experts (physicians and engineers) identified the work associated with MU criteria during patient encounters. They conducted a national survey to assess each criterion’s level of patient benefit and compliance burden. Results In 2015, 480 US family physicians responded to the survey. Their demographics were comparable to US norms. Eighteen of 31 MU criteria were perceived as useful for more than half of patient encounters, with 13 of those being useful for more than two-thirds. Thirteen criteria were useful for less than half of patient encounters. Four useful criteria were reported as having a high compliance burden. Discussion There was high variability in physicians’ perceived benefits and burdens of MU criteria. MU Stage 1 criteria, which are more related to basic/routine care, were perceived as beneficial by most physicians. Stage 2 criteria, which are more related to complex and population care, were perceived as less beneficial and more burdensome to comply with. Conclusion MU was discontinued, but the merit-based incentive payment system within the Medicare Access and CHIP Reauthorization Act of 2015 adopted its criteria. For many physicians, MU created a significant practice burden without clear benefits to patient care. This study suggests that policymakers should not assess MU in aggregate, but as individual criteria for open discussion.

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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