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How will regulators measure the success of meaningful use objectives?

Before National Coordinator for Health IT Farzad Mostashari, M.D., took the stage to deliver his keynote address on the final day of HIMSS 2013, organizers played a prerecorded video message from HHS Secretary Kathleen Sebelius. She spoke briefly about how to measure the success of health IT initiatives, including the meaningful use objectives.

“The true measure of success won’t be the adoption of these tools but how they improve care,” she said, adding that electronic health records should help reduce hospital readmission rates, eliminate duplicative procedures and aid in the prevention of disease.

But just the day before, CMS Acting Administrator Marilyn Tavenner unveiled a new 2013 agenda for her department that spelled out clear goals for provider adoption. The plan seeks to have 50% of physician offices using EHRs and 80% of hospitals receiving meaningful use payments by the end of the year. The plan seems to make provider adoption a central measure of success.

Stage 1 of meaningful use primarily sought to get a broad base of physicians using EHRs. Stage 2 deals more with how physicians use the data from these systems. The disconnect between Sebelius’ and Tavenner’s ideas of success may be related to the ongoing transition from one stage to the next. If the goal of stage 1 is just to get a majority of providers using EHRs then it is entirely appropriate to use adoption rates as a measure of success.

But as the meaningful use program progresses, it will be important for all stakeholders to agree on a method of measuring its success. Will an 80% hospital adoption rate be considered success for stage 2 and beyond, or will a 50% drop in nationwide readmission rates? There’s a pretty big difference between the two measures, and whichever one is used to measure the success of the meaningful use objectives will say a lot about what federal agencies hope to get out of the national investment in health IT.

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