To avoid "needless squandering of resources and significant disruption to the nation's healthcare system," federal officials must change the definition of "meaningful use" as it applies to health information technology implementation.
That's the concern expressed in a five-page letter released today from William F. Jessee, MD, president and CEO of the Medical Group Management Association, to David Blumenthal, MD, national coordinator for HIT for the U.S. Department of Health and Human Services.
"It is clear that the key goals of these health IT investments are to improve healthcare quality, control growth in costs, enhance the efficiency of healthcare administration, stimulate innovation, and ensure the privacy and security of patient information," wrote Jessee, who leads the MGMA, which has 22,500 members.
"At the same time that the definition supports these goals, meaningful use should also be verifiable without creating an undue burden on clinicians and physician practices" especially in the first year of implementation.
Jessee made 15 detailed recommendations for implementation that will help physicians better manage their time and improve quality. Among these are:
- Focus criteria on value and achievability. Targets should be measurable. Goals for improving health should go hand-in-hand with the ability for physicians to integrate these measures into their workflow with minimal disruption or cost.
- Don't impose arbitrary thresholds, such as the requirement that physicians report percentages of patients undergoing specific tests. "Physicians clearly cannot force patients to undergo tests which (i) may be physically uncomfortable for the patient, (ii) one that the patient objects to, or (iii) one for which the patient's health plan covers only part of the cost or none of the cost," he wrote.
- Avoid imposing criteria that do not have widespread experience in small and rural clinical settings.
- Select appropriate administrative criteria. "Those outlined do not take into account the reality of current practice workflow or the inefficiency of the current standards themselves," he wrote.
- Institute a pilot before the 2011 program start date with a small number of vendors and in a variety of physician practice settings.
- Provide logistical support prior to implementation, such as through guaranteeing timely response from the Centers for Medicare and Medicaid Services once data are submitted and allow acceptance of meaningful use data in late 2010 so doctors can send test data and receive feedback.
- Give physicians a report on meaningful use achievement and sufficient time to restructure their systems rather than providing "simplistic pass/fail" structure.