A doctor's dilemma: Meaningful use lacks meaning

I have had an EHR in place for almost 10 years, long before the meaningful use program was born. Yet, the technology has not yet evolved to where it is purported to be. Interoperability has been a key goal and would greatly transform medical care when it comes into existence. However, my practice has not been able to make our EHR interoperable with other parts of my system.

Further, meaningful use is said to improve clinical outcomes of patients, but the metrics doctors must report are often time-consuming and provide no proven improvements in clinical care. This time is often taken from face-to-face interactions with our patients. We cannot make eye contact with the person in front of us and input information into the computer at the same time. Many patients complain that doctors now care more about their computers than the people they are caring for. There has to be an easier way of reporting meaningful use.

Doctors do not feel the required metrics are meaningful to the medical care of our patients. One example is recording smoking status at every office visit. While counseling patients on the dangers of smoking is very important, it does not improve the health of an infant to spend time recording in their chart that they have not taken up smoking since their previous visit.

Who truly knows what is important in the exam room more than doctors? If MU is to have any true medical meaningfulness, doctors need to be asked to give input. Otherwise, they are just another set of mandates we feel burdened to comply with.

While the intention of MU may be good (i.e., improving patients’ outcomes), it has not demonstrated any true meaningfulness to those practicing medicine on a daily basis. Before these mandates were derived, it would have been better to ensure that the technology was established to allow us to use it in our daily work. The EHR companies have failed to deliver on interoperability, as just one example. But, this is a key point that doctors need to find meaning in the process. Perhaps, it's time to step back from MU and penalizing doctors and fix the inefficiencies in the technology first. When that is repaired, ask the ones on the frontlines of medicine — doctors — to play a role in the development of any guidelines. If these issues are not addressed, we may have a MU program, but it will never be truly meaningful.

Linda Girgis MD, FAAFP, is a family physician in South River, N.J. She has been in private practice since 2001. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter's University Hospital and Raritan Bay Hospital. She teaches medical students and residents from Drexel University and other institutions.  Dr. Girgis earned her medical degree from St. George's University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year.  She is an Advisory Board member for the Sermo online physician community. She is a blogger for Physician's Weekly and the Library of Medicine, where she is one of their featured physicians. Additionally, she has been a guest columnist and contributor to several other media outlets. She authored the book “Inside Our Broken Healthcare System” and has been interviewed in US News and on NBC Nightly News. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.