Meaningful Use of Electronic Health Records: Experiences From the Field and Future Opportunities
- PMID: 26385598
- PMCID: PMC4704893
- DOI: 10.2196/medinform.4457
Meaningful Use of Electronic Health Records: Experiences From the Field and Future Opportunities
Erratum in
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Metadata Correction: Meaningful Use of Electronic Health Records: Experiences From the Field and Future Opportunities.JMIR Med Inform. 2015 Sep 25;3(3):e32. doi: 10.2196/medinform.5160. JMIR Med Inform. 2015. PMID: 26407141 Free PMC article. No abstract available.
Abstract
Background: With the aim of improving health care processes through health information technology (HIT), the US government has promulgated requirements for "meaningful use" (MU) of electronic health records (EHRs) as a condition for providers receiving financial incentives for the adoption and use of these systems. Considerable uncertainty remains about the impact of these requirements on the effective application of EHR systems.
Objective: The Agency for Healthcare Research and Quality (AHRQ)-sponsored Centers for Education and Research in Therapeutics (CERTs) critically examined the impact of the MU policy relating to the use of medications and jointly developed recommendations to help inform future HIT policy.
Methods: We gathered perspectives from a wide range of stakeholders (N=35) who had experience with MU requirements, including academicians, practitioners, and policy makers from different health care organizations including and beyond the CERTs. Specific issues and recommendations were discussed and agreed on as a group.
Results: Stakeholders' knowledge and experiences from implementing MU requirements fell into 6 domains: (1) accuracy of medication lists and medication reconciliation, (2) problem list accuracy and the shift in HIT priorities, (3) accuracy of allergy lists and allergy-related standards development, (4) support of safer and effective prescribing for children, (5) considerations for rural communities, and (6) general issues with achieving MU. Standards are needed to better facilitate the exchange of data elements between health care settings. Several organizations felt that their preoccupation with fulfilling MU requirements stifled innovation. Greater emphasis should be placed on local HIT configurations that better address population health care needs.
Conclusions: Although MU has stimulated adoption of EHRs, its effects on quality and safety remain uncertain. Stakeholders felt that MU requirements should be more flexible and recognize that integrated models may achieve information-sharing goals in alternate ways. Future certification rules and requirements should enhance EHR functionalities critical for safer prescribing of medications in children.
Keywords: electronic health records; health policy; meaningful use; medical informatics.
Conflict of interest statement
Dr Bates and Dr Lehmann have served as members of the HIT Policy Committee. Dr Huff has served as a member of the HIT Standards Committee.
References
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- HealthIT.gov. 2015. [2015-05-24]. Health IT regulations: meaningful use regulations http://www.healthit.gov/policy-researchers-implementers/meaningful-use-r... .
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- Department of Health and Human Services, Office of the National Coordinator for Health Information Technology Request for Comment Regarding the Stage 3 Definition of Meaningful Use of Electronic Health Records (EHRs) 2013. Jan 14, [2015-09-13]. http://www.healthit.gov/sites/default/files/hitpc_stage3_rfc_final.pdf .
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- regulations.gov. [2015-04-08]. Your voice in federal decision-making http://www.regulations.gov/
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- EHR Incentive Program Eligible Professional Meaningful Use Menu Set Measures Measure 6 of 9. 2014. May, [2015-04-08]. Medication reconciliation http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentiveProg... .
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