On Day 2 of the Government’s Hearing on Meaningful Use, there was finally some recognition of the need for physicians to be able and actually willing to use their EMRs. Three speakers from the audience, including SRS, presented testimony reminding Committee members of the dismal track record of traditional EMRs to date, and warning that different results should not be realistically expected simply because financial incentives are offered. It was clear from the concerned looks and head-shaking by the Committee members that they were starting to acknowledge that CCHIT was not the easy answer they had expected to the complex issues surrounding adoption and meaningful use of an EMR.
Dr. David Classen, from the University of Utah and Computer Sciences Corporation gave very interesting testimony in which he suggested that the focus must be on finding EMRs that anticipate the needs of users and are easy to use. While some standard criteria should be established, he maintained that the issue is implementation and use, not criteria alone. In fact, he shared results from a study in which a number of major CCHIT-certified products did not fare very well in meeting several test measures of improvement in quality of care. When asked about the correlation between performance on these measures and specific product criteria, he responded that he did not find any.
While no specific alternatives were put forth, “usability” was identified as an important criteria. This means more than simply adding a usability measure to existing CCHIT criteria. It means ensuring that the EMRs included in the legislation add value to physicians’ practices, and maintain or enhance, rather than decrease, their productivity. It also means “usable” by all physicians, not just primary-care physicians—the providers around whom the “meaningful use” discussion continues to be based. Our testimony, which was echoed by the other speakers, emphasized that the only way enduring adoption and true meaningful use will occur is if physicians themselves deem their EMR usable. There can be no “meaningful use” without actual use, and we will not see any of the anticipated quality-of-care and cost benefits if physicians are not using the EMRs we incent them to buy.
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