Tuesday, May 15, 2012
I am delighted to be speaking at the Fourteenth Annual SIH/SIU Health Policy Institute later this week and honored to be included in a great group of speakers, here. I've been asked to do a summary of how we got to the current state of "Meaningful Use" (MU) and provide a critical analysis of the subsidy program. Obviously this has both quantitative and qualitative aspects. The former inquiry has been particularly challenging; I have been faced with a veritable soup of confusing data. For example, exactly what are the data in all those charts about the growth of EMR utilization, are they providers who have registered for MU, or attested, or received funds? When you read about the numbers of providers who have adopted EMRs is that limited to eligible providers and to users of certified technologies?
Moving to more qualitative aspects, exactly what technologies are being used? Are these smart EMRs that are integrated with sophisticated prescribing and clinical decision support technologies, or the EMR version of dumb-phones? And when a study notes a strong uptick in meaningful use, is that for real, or have the providers been able to punt on some of the harder objectives or report on measures with extremely low numbers of participating data subjects? It strikes me that there's still a lot of government and industry cheerleading going on out there, abetted by cherry-picked data.
I am also trying to move beyond the MU weeds and reflect on the thorny safety/regulatory issues as well as the still unsolved privacy and security questions. You have probably read about the value of "big data," and if not this McKinsey report is a fine primer. I confess that I had to look up what a zettabyte of data was! I will also try and reflect on ACA, EMR-based research, and future conceptions of health data, at least until the moderator loses patience and pulls the power from my slide deck. Maybe I'll see you there! [NPT]