While the government is starting to think about Stage 3, it hasn't yet begun Stage 2 of Meaningful Use, which starts next year. And although Stage 3 will not go into effect until 2016, the government has already released preliminary recommendations for its requirements. The HITECH portion of the American Recovery and Reinvestment Act (ARRA) of 2009 specifically mandates that incentives should be given to Medicare and Medicaid providers not for EHR adoption, but for "meaningful use" of EHRs.
In July of 2010 and August 2012, HHS released that program's final rule defining Stage 1 and Stage 2 Meaningful Use. The government states it is "strongly signaling" that that the bar for what constitutes Meaningful Use would be raised in subsequent stages in order to improve advanced care processes and health outcomes.
While EHR use is increasing dramatically, there are many flaws that must be overcome, especially, day-to-day sloppiness in use of records. Doctors and other providers are "cutting and pasting" information haphazardly to improve EHR efficiency, but their quick actions are likely to be detrimental to overall recordkeeping and patient care in the long run.
In addition, physicians are using dictation tools that are eliminating the traditional "editing" process of their work, which results in errors, Dougherty says.
Dougherty wasn't alone in her concerns about the EHRs among those who testified before the HIT committee. "All too often a patient's medical information is inconsistently stored—many times in multiple locations, within disparate systems that are not interoperable," Rosemary Kennedy, PhD, MBA, RN, FAAN, VP for health information technology, the National Quality Forum, told the committee.