G Talley Holman1,2, Steven E Waldren3, John W Beasley4,5, Deborah J Cohen6, Lawrence D Dardick7, Chester H Fox8, Jenna Marquard9, Ryan Mullins10, Charles Q North11, Matt Rafalski12, A Joy Rivera13, Tosha B Wetterneck14,15. 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
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.
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.
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