Meaningful Use, non-compliance and un-healthy behavior

In its attempt to get physicians to buy into the MU concept and receive the funds available through ARRA, the gov stipulates that docs will need to demonstrate that they meet certain criteria— the majority of which are pretty much laid out already.   ONC has announced and laid out the initial structure of those criteria.  Unfortunately for physicians, a significant percentage of Stage I criteria will relate to changes in patient behavior, changes in patient patterns of med renewals, adherence to tx protocols, etc.

 Am I the only person who see a significant problem with this???

Lets take a big step back…. computers, technology and computing platforms are enabling mechanisms,  They can accelerate, mechanize, auomate or enhance  current work flows, etc.  What if  we layer technology on top of an inefficient, poorly controlled, nontransparent *sick* health care system—what’s going to happen…. we will make a sick, broken system work faster and probably far less efficiently (most docs report drop in patient load, etc after go live dates).

We as physicians  truly have little data or valuable tools proven to reliably and effectively incent patients to change un-healthy behaviors, convince them to take their medicine or even follow up in the office when their symptoms are not improving.  I will follow Jen McCabe’s work closely since she may have something to address this…. but the answer or solution alludes us right now. 

So we have a system that is  incapable of getting patients to change un-healthy behavior patterns, and we are about to embark on a multi-billion dollar initiative to electronically capture our abysmal results at changing behavior and nothing in those proprietary silos of code or data will help the patient see the error of their ways.  

So, why are we doing this? Or more important, why are we starting here ???

 Will it be possible to meet even the *mild* stage I MU criteria if nearly 40% of those criteria deal directly with patient adherance to protocols, changing un-healthy behavior patterns and improving medication effectiveness (by actually taking the pills).  Since we have no data on how to do this, my guess is the answer is no.  If the physician only needs to demonstrate that they are trying to do this, then what use are these elaborate, complex proprietary electronic platforms we have to spend a ton of money to purchase for ? 

After all… the goal of health care reform, ARRA, etc is to improve our health, improve access to health care and improve the quality of care the system deliver.  Sadly it appears our current gov enabled initiatives will fail at this.    We need to find the proper path… and we all have incentive to do so… after all.  WE ARE ALL PATIENTS !!


About hjluks

A busy Academic Orthopedic Surgeon, Digital Strategist, Chief Medical Officer and father... intently and efficiently navigating the intersection of Social Media and Health Care.
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