Effect of Meaningful Use on EHR Adoption ‘Insignificant,’ Study Finds

The meaningful use program and its incentive payments have not had a statistically significant effect on providers’ adoption of electronic health records, according to a study published in theJournal of the American Medical Informatics Association,FierceEMR reports (Durben Hirsch, FierceEMR, 8/7).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Study Details

The study was conducted by researchers from the public health schools at:

• Indiana University;
• Johns Hopkins University; and
• The University of Alabama.

The researchers reviewed 13 years’ worth of data from the National Ambulatory Medicare Care Survey (Goedert [1], Health Data Management, 8/12). The study excluded:

• Anesthesiologists;
• Pathologists; and
• Radiologists.

To gauge the effect of the incentive program on EHR adoption, the researchers analyzed an EHR diffusion chart, plotting sales and share of the potential market (FierceEMR, 8/7).

Study Findings

According to the study, overall EHR adoption between 2001 and 2013 could have increased by as much as 7 percentage points “above the level predicted in the absence of” the program’s incentives.

Specifically, under one model, the researchers predicted that the EHR adoption rate by 2017 would reach about 90% under the meaningful use program, compared with 83% in the absence of incentive payments.

However, the researchers noted that the increase was statistically insignificant. Further, the adoption rate was smaller under various “model specifications” (Goedert [1], Health Data Management, 8/12).

In addition, the study found that the meaningful use program and its incentive payments “contributed statistically insignificant nudges to the EHR diffusion curve of less than one percentage point and a half percentage point, respectively.”

The researchers concluded that there is “weak evidence” that the meaningful use program affected EHR adoption.

They noted that the program might have contributed only to the “inevitable” adoption of EHRs and could have had negative unintended consequences (FierceEMR, 8/7).

Blog Post Contests Findings

In a Health Data Management  blog post, news editor Joseph Goedert questions the study’s findings.

He notes that some of the data used in the study were old and that researchers missed some statistics, such as how the number of eligible professionals who registered for the Medicaid and Medicare meaningful use program increased by hundreds of thousands between 2011 and 2012.

Goedert argues that the rate of EHR adoption would not have been so high “absent the meaningful use program.” He writes, “Doctors adopted on a fast-track because meaningful use was a government mandate that included subsidies for participating and financial penalties for non-compliance. Some things are that simple” (Goedert [2], Health Data Management, 8/12).