You can lead doctors to EHR systems — but you can't make them attest.
A poll of nearly 2,000 physicians, in fact, reveals that 55 percent do not plan to attest for meaningful use Stage 2 in 2015.
Medical Practice Insider teamed with SERMO to ask members of its physician community about their attestation intentions in the coming year. We posed one simple yes-or-no question: Do you plan to attest for Stage 2 in 2015?
The answer? Doctors are opting to forego Stage 2 by a margin of 994 to 822 participants.
Status check: MU participants
About 75 percent of office-based primary care physicians had some form of EHR system in 2012, according to the National Ambulatory Medical Care Survey, conducted by the National Center for Health Statistics.
Since the 2009 enactment of the HITECH Act, which established the Medicare and Medicaid EHR Incentive Programs for eligible professionals (EPs) and hospitals, nearly two-thirds of physicians who implemented health IT tools said financial incentives and penalties were a major influence to adopt such systems.
EPs have been paid nearly $10 billion by the Centers for Medicare and Medicaid Services under the meaningful use program to date. Only 3,655 unique Medicare EPs had received payments for Stage 2 attestation as of early December, however, compared to 268,686 EPs for Stage 1.
Harsh realities for doctors
Individual comments from surveyed SERMO members show a variety of reasons — some financially motivated, others not — for physicians deciding that they've had enough with the meaningful use program and will go no further.
"I did Stage 1 in years one and two, but it is almost impossible to do Stage 2. It requires patients to have emails and engage my EHR,” one cardiologist explained. “Well, I have a lot of patients in their 80s and 90s, and they don’t have computers, let alone email."
A family practitioner who CMS said was in the top 3 percent in terms of readiness and reporting is now at a crossroads.
"I’ve done Stage 1 three times now. I have the option to do either Stage 2 or Stage 1 for the fourth time. I would rather stay with Stage 1 for now because my patients are reluctant to use messaging and I personally do not like the interface for my portal,” the family practitioner noted. “I do not have too many Medicare patients even though I am participating in an ACO, so I am not concerned much about a penalty. I just want the software to be perfected and be more usable."
An internist echoed that last point about usability: "Every night there’s more chart work. I can’t find things in the patient chart easily, and it's hard to compare current and old EKS’s, current and old labs."
A rheumatologist, meanwhile, said that the administrative costs exceed any financial gains, meaningful use incentives and otherwise. “I am re-examining getting on an MU-certified EMR in 2015 as interoperability and eRx systems tend to mature and become more prevalent."
And then there’s the old-fashioned preference for paper.
"Because I don’t use an EMR, my work is easier, profits are better,” a gastroenterologist commented, “and I get my work done in 30 percent of the time it takes EMR-equipped hospital doctors."
Small practice mantra
It’s important to point out that the above comments are from specialists, a collective that often faces unique meaningful use challenges — particularly when it comes to core, menu and clinical quality measures engineered for providers with a broader swath of patients and services, making it easier to fulfill those requirements.
A family practitioner, however, shared what appears to be something of a mantra among medical practices deciding whether or not to pursue Stage 2.
"The following sentence is false 100 percent of the time: 'We completed meaningful use stages 1 and 2 and as a consequence the care we provide for our patients has improved.'”
What is your opinion on the meaningful use program at this stage? Will you continue onward? What is your rationale? Please comment below.