Meaningful use's benefits and burdens for US family physicians

• Published in: Journal of the American Medical Informatics Association : JAMIA 2018-06, Vol.25 (6), p.694-701
• Main Authors: Holman, G Talley, Waldren, Steven E, Beasley, John W, Cohen, Deborah J, Dardick, Lawrence D, Fox, Chester H, Marquard, Jenna, Mullins, Ryan, North, Charles Q, Rafalski, Matt, Rivera, A Joy, Wetterneck, Tosha B
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Attitude to Computers; Electronic Health Records - legislation & jurisprudence; Electronic Health Records - standards; Health Care Surveys; Health Policy; Meaningful Use - legislation & jurisprudence; Medicare - legislation & jurisprudence; Physicians, Family; Reimbursement, Incentive - legislation & jurisprudence; Research and Applications; United States
• ISSN: 1067-5027; 1527-974X
• DOI: 10.1093/jamia/ocx158

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. 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. 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. 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. 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.