Healthc (Amst) - Meaningful use: Floor or ceiling?

Tópicos

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Resumo

CKGROUND: In 2011, federal incentive payments for meaningful use of electronic health records (EHRs) began. This study evaluates the impact of the program on hospitals and EHR vendors, identifying how it affects EHR planning and development. Specifically, it assesses whether vendors and Chief Information Officers (CIOs) are viewing the meaningful use requirements as a floor - the minimally acceptable level of implementation, upon which development continues - or as a ceiling - the upper-bound on EHR development and implementation.METHODS: The study combines interviews with EHR vendors and hospital CIOs with EHR adoption data from American Hospital Association surveys. Results from interviews with 17 hospital and system CIOs (representing 144 individual acute-care hospitals) and 8 EHR development executives (representing two-thirds of installations) are detailed. Furthermore, it compares adoption of two key EHR functions, BCMA and CPOE, which are treated differently under stage 1 of the incentive program.RESULTS: Three key findings emerge from the study. First, meaningful use requirements can serve as either a floor or a ceiling, depending on the abilities of institutions implementing EHRs. Second, the increasing focus on achieving meaningful use across both hospitals and vendors risks missing the forest of health care system change through the trees of meeting discrete requirements. Third, while the meaningful use incentive program has accelerated the development and implementation of some key functions, it has also slowed development of others.CONCLUSIONS: Policy makers should craft subsequent stages of the incentive program to ensure smaller facilities and additional features necessary for health care system change are not left behind.

Resumo Limpo

ckground feder incent payment meaning use electron health record ehr began studi evalu impact program hospit ehr vendor identifi affect ehr plan develop specif assess whether vendor chief inform offic cio view meaning use requir floor minim accept level implement upon develop continu ceil upperbound ehr develop implementationmethod studi combin interview ehr vendor hospit cio ehr adopt data american hospit associ survey result interview hospit system cio repres individu acutecar hospit ehr develop execut repres twothird instal detail furthermor compar adopt two key ehr function bcma cpoe treat differ stage incent programresult three key find emerg studi first meaning use requir can serv either floor ceil depend abil institut implement ehr second increas focus achiev meaning use across hospit vendor risk miss forest health care system chang tree meet discret requir third meaning use incent program acceler develop implement key function also slow develop othersconclus polici maker craft subsequ stage incent program ensur smaller facil addit featur necessari health care system chang left behind

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