In 2016, MU as it has existed– with MACRA– will now be effectively over and replaced with something better #JPM16
— Andy Slavitt (@ASlavitt) January 12, 2016
Earlier this week, Andy Slavitt, the Centers for Medicare and Medicaid Services Acting Administrator, tweeted that “In 2016, MU as it has existed– with MACRA– will now be effectively over and replaced with something better”. This follows a statement made by Dr. John Halamka, CIO of Beth Israel Deaconess Medical Center, in his blog post a few months ago that Meaningful Use has served its purpose.
These comments are not entirely surprising considering the bad sentiment that physician groups and others have had towards Meaningful Use in recent years. The general feeling across much of the industry is that the focus needs to shift more specifically to better outcomes now that much of the technology is in place.
While some of the higher thresholds proposed for Meaningful Use Stage 3 could be considered steps toward better outcomes, the direct linkage between outcomes, thresholds, and metrics was harder to visualize in the Stage 3 proposed rules.
Another concern with Meaningful Use was that many clinicians, such as radiologists and other specialist, were being forced to fit a square peg into a round hole. A better way to approach the varying workflows of healthcare would be to allow physicians to customize IT applications and goals for outcomes around their specific practices. This incents software vendors to develop workflow-specific technology rather than focusing all efforts on Meaningful Use compliance and then forcing all workflows to fit into that software.
Patient engagement is an area where Meaningful Use likely got a failing grade. Most providers had much difficulty to even get the required 5% of their patients to access health information after a visit. If there is no longer a 5% metric, will that free up application developers to get creative about giving patients the access and functionality they want? Or, will patient engagement just be ignored with no metric in place? Time will tell, but with a low benchmark of 5%, was the industry really making progress engaging the patient population?
One positive note regarding Meaningful Use Stage 3 was the requirement for Open APIs. Many in the industry were excited to see this requirement, with the hopes that it would lead to better interoperability. Some took this requirement as the unofficial endorsement of HL7 FHIR, which could be used to satisfy the Open API requirement.
It would be sad to lose momentum on this effort, but John Halamka stated in his blog that he believes that health IT developers have already committed to APIs and thus Meaningful Use would not need to continue to justify this effort.
While, officially, Meaningful Use is still alive, the fact that prominent people in the industry have made statements as those above puts the writing on the wall for what is likely to happen. There are other initiatives in place, such as ACOs and Patient-Centered Medical Homes, which are driving better outcomes in their own way.
The time has probably come to let Meaningful Use go to the wayside.