Reviewing Meaningful Use to Accelerate Success?

A research team recommends policymakers for reviewing meaningful use or transition from Stage 1 Meaningful Use to Stage 2 that facilitate a successful transition to MIPS.

To make sure the consistent clinical quality when transitioning from Stage 2 Meaningful Use to Advancing Care Information under MIPS, policymakers should consider reviewing meaningful use and the initial transition from Stage 1 to Stage 2 Meaningful use.

In a latest study published in the Journal of the American Medical Informatics Association, researchers did merely that — assessing and reviewing the consistency of clinical quality as healthcare agencies progressed through the first 2 phases of meaningful use.

The research team evaluated a longitudinal research at hospitals affiliated with Brigham and Women’s Hospital between the month of September and November 2012 and October and December 2014. These were the timeframes during which the network attested to Stage 1 and Stage 2 Meaningful Use, respectively.

During these time periods, the researchers looked at the 7 clinical quality measures that sustained consistent between the 2 stages of the program: influenza immunization, hypertension control, and counseling, tobacco use assessment, diabetes control, senior weight screening follow-up, Chlamydia screening, and adult weight screening and follow-up.

From one program stage to the next, the researchers observed betterment in hypertension control (35 to 40%), influenza immunization (63 to 68%), tobacco use assessment and counseling (86 to 96%), and diabetes control (93 to 96%).

Senior weight screening worsened from 54% in Stage 1 Meaningful Use to 49% in Stage 2 Meaningful Use. Adult weight and Chlamydia screening sustained to be consistent.

“While our research doesn’t make a causal link between the transition to MU2 and quality, it recommends that few of the elements, like electronic reporting of clinical quality measures at stricter thresholds, secure messaging, and information exchange, might have a positive impact on quality,” the researchers concluded.

While the Advancing Care Information performance category does involve several differences from meaningful use, it yet consists some of the same elements. This might be depicted in reviewing meaningful use and transition from Stage 1 to Stage 2 Meaningful Use.

“Several elements of MU2 are preserved in the proposed rule, like mandated reporting of institution-selected quality measures at stricter thresholds, secure messaging, and information exchange,” the researchers elaborated. “Hence, the affect of reviewing meaningful use and transitioning from MU1 to MU2 has significant implications for the latest policy, specifically for agencies that will be transitioning directly from MU1 to the latest program.”

Given these outcomes, the researchers recommend the following steps for the development and progress of MACRA implementation.

First, CMS should make sure that the MACRA measures are rooted in evidence that shows they will make better the outcomes. For instance, the CMS proposal to remove clinical decision support might not be effective because there is little evidence to recommend that clinical decision support limits care quality. In accordance to the researchers, most evidence proves that clinical decision support really improves quality.

However, scant evidence supports the efficiency of secure direct messaging between patient and provider. The researchers recommend CMS look at measures to make sure that they are not inquiring eligible clinicians to report measures that aren’t proven to empower care quality. Rather, CMS should conduct research to evaluate how effective this measure is.

Second, the researchers recommend CMS continue setting a high bar for providers. The heightened expectations providers were subject to in Stage 2 Meaningful Use compared to Stage 1 might have been a driving factor behind the increased care quality. Should providers be held to a lower or more stagnant standard, they may not continuously improve quality.

Third, CMS should review how providers utilize certified EHR technology for clinical quality measures reporting.

Fourth, CMS should make certain that providers can track their Advancing Care Information progress through their own EHRs. In accordance to the researchers, several providers were capable to do this during either stage of meaningful use and found it useful for their successful program attestation. Such abilities could likewise be beneficial under MACRA.