Why Doctors Call It Meaningless Use

In the last week I have received three documents from hospitals that illustrate what physicians find so frustrating about the MU (Meaningful Use) program.

Example #1: Patient’s wife calls me for an appointment regarding three episodes of passing out. On obtaining the emergency room records there is no mention that the patient lost consciousness. In fact, there is no story whatsoever regarding the patient’s presentation or symptoms. All that is in the document is lab values. I can tell that the ER physician evaluated the patient for a heart attack which is not a typical workup for passing out.

Example #2: Patient presented to the emergency room with shortness of breath. As far as I can tell she was given four nebulizers (breathing treatments) and sent home with no new medications or orders. What?

Example #3: This was a discharge summary following hospitalization. It lists the patient’s allergies, lab reports, radiology tests and medications but yet again, I don’t have the patient’s story or the other physicians’ thoughts on how treatment progressed and how the patient did, in other words, the narrative that physicians use to communicate with other physicians is completely missing.

After receiving those documents early in the week two more were faxed. Thankfully, these give me a Paul Harvey “rest of the story”.  So how is this meaningful?  The information I need to care for my patients was not contained in the first documents whose sole use is to fulfill meaningful use requirements. I am forced to look at two documents when one would not only suffice but actually be helpful. This wastes my time in an already time-stressed schedule. It is neither meaningful nor useful.

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A Call to Action from HiMSS

For those of you who are not geeks, or not healthcare geeks, I have spent the last week in Chicago at the biggest HIT (Health IT) “geek-out” in the world. Some 42,000+ people gathered in Chicago for the annual HiMSS (Health Information Management Systems Society) meeting. It is truly an overwhelming experience. On the first full day of the conference I got lost twice. Not an IMG_8195auspicious start.
As a member of the Connected Patient Committee for HiMMS, I participated in the Patient Engagement Symposium which brought together individuals passionate about using HIT to improve health in patients and communities. ONC representative Lana Moriarty (Office of the National Coordinator) spoke to the government’s goals along these lines. E-patient Dave Bronkart, a celebrity among patients passionate to change our healthcare system into a patient-centered and patient-empowered one,  came to watch  his personal physician discuss changing care models and shared decision making. Amy Gleason of CareSync presented the patient’s viewpoint when it comes to dealing with multiple portals. The highlight of the day was a call to action, voiced below in the video by Regina Holliday, well-known advocate for patient access to medical records. The “call” was made by Dr. Farzad Mostashari, former National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. On the day before the conference began, CMS (Center for Medicare Services) proposed dropping the Meaningful Use (MU) requirement in Stage 2 (of three) from 5% of patients being able to view, download or transmit their medical records to ONE patient. Most individuals in the patient advocacy arena feel this proposed change sends a message to health systems and providers that patient access to their records is either no longer a priority or special interests have pushed this change of heart. This seems particularly odd in an environment of increased encouragement of patient involvement in their own healthcare.  NoMUwithoutMEDr. Farzad, e-patient Dave, Ms. Holliday, and myself are just a few of the many individuals who think this is the wrong message to send. As a consequence a Day of DataIndependence on July 4 has been declared, and patients are asked to request electronic access to their medical records by calling their physicians and hospitals and asking for their medical records in electronic format.
If access to your medical records, or your family’s medical records, is important to you (and it certainly should be!) watch this space for more information in the next few weeks.  For information from the Society for Participatory Medicine regarding this issue, follow this link: No MU without ME.

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