Meaningful use: Good for business

'It has dramatically accelerated the adoption of IT. But there's been a lot of unintended consequences.'
By Mike Miliard
07:25 AM

Remember the old days? Way back before 2009? Healthcare had some catching up to do. But no one quite knew just how to do it.

So much of the industry was still paper based. Where technology was deployed, it was often siloed systems in ancillary hospital departments, or rudimentary software helping to run physician practices.

"For such a knowledge intensive industry, healthcare had done a terrible job at leveraging IT to manage and distribute such knowledge," says John Moore, founder and managing partner of Chilmark Research. "There was very low adoption rates. Very poor – on the order of 10 or 15 percent."

"Ten years ago, what this industry was in need of was a catalyst," says Sean Wieland, managing director and a senior research analyst at Piper Jaffray. "But the ROI for implementing these very expensive systems is questionable. I think that has never been a very compelling aspect of the sales proposition – especially for electronic health records."

In the wake of the 2008 financial collapse, an opportunity presented itself. As Michael Grunwald, author of The New New Deal: The Hidden Story of Change in the Obama Era (Simon & Schuster) – which tells the story of the 2009 American Recovery and Reinvestment Act – told Healthcare IT News in 2012, disbursing money for health IT adoption through the HITECH act was a "no-brainer."

[See also: Q&A: Michael Grunwald on the 'no-brainer' of health IT and ARRA's lasting impact]

After all, he said, "It's preposterous that you have to fill out the same 20 forms every time you go to the doctor's office. And that two doctors who aren't in the same room can't look at the same file. And that if you show up at a hospital on the weekend they have no way of seeing the test that you took on Wednesday and you have to retake it. And that your doctor could kill you with his chicken-scratch handwriting. It's just crazy."

Fixing that appealed to President Barack Obama, "who really is this sort of rationalist, pragmatist, sort of policy guy," he said. "People had been squabbling over the details for several years; the prospect of $27 billion really did focus the mind."

It also turbocharged an entire sector of the economy.

"Obama's stimulus was the catalyst that lit this industry up five years ago," says Wieland. "We haven't looked back since."

[See also: ARRA changes game for IT projects]

In a busy decade for healthcare, meaningful use would seem the be the signature event.

"As much as I have some misgivings about it, I would have to say it has been," says Moore. "It has dramatically accelerated the adoption of IT," he says. "But there's been a lot of unintended consequences as a result of this."

For one thing, Stage 1 criteria had hurdles that were fairly low. Understandable, sure, since widespread adoption was the goal. "But I believe also that these artificially low barriers allowed a lot of EHR vendors that frankly should have gone the way of the dodo to continue to exist," says Moore.

The stimulus was "a huge shot in the arm" to a lot of companies that may not have deserved it, he says. "Unfortunately a lot of providers were just going out and buying whatever they could find that was certifiable for Stage 1. And now they're stuck with systems that really don't fit what they need."

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