Speaking of choices, those planning to attest to Stage 2, are allowed to pick 3 measures out of 6 menu choices, two of which are practically impossible to choose, since not many States have the ability to receive electronic data to cancer, or some other registry (other than immunizations), and also because almost all 2014 certified EHRs chose to not certify themselves for these measures. Realistically, there are no menu choices for Stage 2, and we should have probably never expected any, based on recalling that back in 2011 many EHRs were certified for functionality they didn’t really have (e.g. immunizations interfaces in all 50 States).
Another baffling set of numbers comes from this year’s National Ambulatory Medical Care Survey (NAMCS). A joyfully reported 78.4% of physicians in the U.S. have an EHR, and 48.1% have a “basic” one (i.e. an EHR with functionalities that could satisfy basic Meaningful Use requirements), or better. The question that always springs to my mind looking at this graph is what on earth do 30% of doctors have in their practice? Microsoft Office? There is practically nothing you can buy today that does not meet the definition of “basic”, yet the gap between basic EHR and any EHR, shows no signs of narrowing down, which in my mind, makes these survey results questionable at best, but I digress.
The 48.1% of basic EHR users matches very well with the approximately 350,000 physicians that are participating in the Meaningful Use program. The NAMCS also finds that 13.1% of physicians are ready for Meaningful Use Stage 2, which means that practically all physicians that started their Meaningful Use journey in 2011 were using a 2014 certified EHR and were ready to move up the ONC escalator at the time they were surveyed. Considering that the “2013 NAMCS EHR survey was conducted from February through June 2013”, I doubt that very much, seeing that there were no 2014 certified EHRs on the market at that time. Perhaps those optimistic doctors meant that they are confident that they (and their EHR vendors) will be ready when the time comes.
Either way, we are left with over a quarter million doctors who don’t think they are ready for Meaningful Use Stage 2, and perhaps unbeknownst to them, they are also not ready for Meaningful Use Stage 1, which requires this year a brand new, 2014 certified EHR, and another two hundred thousand physicians who think they have an EHR, but really don’t. If 2014 was designed to stress test the $18 billion (so far) Meaningful Use program, odds are the crash will be spectacular. If, on the other hand, the thinking was that as long as the camel is on the move up the escalator, we can happily add bale of straw after bale of straw to its back ad infinitum, we’re in for a bit of a surprise this year.
Margalit writes regularly about intersection of healthcare & technology on her site: On Health Care Technology