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While the technological changes made by some healthcare providers to attest to the first two stages of the meaningful use program might have been costly and occasionally burdensome, the program succeeded in its primary goal of increasing the number of physicians using EHRs.
In evaluating meaningful use, years after it was introduced along with the HITECH Act as part of the American Recovery and Reinvestment Act of 2009, it's clear that many physicians and healthcare organizations met much of the criteria of stages 1 and 2 of the program. When the stage 3 proposal was met with diminished enthusiasm, some people within the healthcare industry began to wonder if the end of the meaningful use program was near. In response to the tepid reaction of some physicians and hospitals towards the third and final stage of meaningful use, the Centers for Medicare and Medicaid Services (CMS) proposed to introduce a new program that could eliminate meaningful use altogether.
On Jan. 11, 2016, the acting administrator of CMS, Andy Slavitt, spoke about the future and the end of meaningful use at the J.P. Morgan Annual Healthcare Conference. He detailed a set of changes that will effectively replace meaningful use, though he stated the agency's goals continue to be population health and satisfying the needs of physicians. Slavitt didn't sidestep the issue of meaningful use's future in stating, "The meaningful use program, as it has existed, will now be effectively over and replaced with something better."
Over the past few years, many physicians, medical associations and other health entities have voiced their concerns and provided feedback on the meaningful use program. As a result of that accumulated feedback, CMS recognized that a change in the program was needed. Slavitt explained that CMS is taking a different approach to meeting its stated goals and that the new program replacing meaningful use will concentrate on slightly different items. Of the four topics discussed by Slavitt, some focus on providers and others on technology vendors.
The end of meaningful use and its replacement
The first area that CMS will address with its upcoming program will be how it measures physician performance. The plan calls for a shift away from measuring physicians' technology use when evaluating their treatment of patients. This adjustment pleases many health professionals because some of them felt they spent more time at computer screens than interacting with and caring for patients.
Andy Slavittacting administrator of CMS
Allowing healthcare providers to have a say in the determining how their performance is measured is something else CMS plans to accommodate after the end of meaningful use. This adjustment is likely going to help eliminate some of the challenges that some medical specialties faced when attempting to meet meaningful use that did not apply to them. In those cases, the specialists were forced to apply for meaningful use hardship exceptions, which was an additional step that could be eliminated if specialty groups have some influence over how they are graded in the future.
Another area of focus will be the utilization of EHR systems. EHR vendors were required to be certified by an authorized testing body for their products to be eligible for meaningful use. While many EHR systems were meaningful use-approved, they remained closed to competing EHR systems and created roadblocks to health data interoperability. Officials from ONC have previously said greater interoperability between healthcare systems is a critical goal of theirs. Andy Slavitt echoed that statement and said CMS is "deadly serious about interoperability." He also said the practice of information blocking by EHR vendors -- which occurs when they purposely make their data inaccessible to other vendors -- will not be tolerated.
Though it might not happen this year, the changes proposed by CMS in will likely affect providers and patients. It is also too soon to tell how physicians and hospitals will react to the end of meaningful use, but it's clear that CMS will support physicians in their use of technology to improve the health of their patient populations.
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