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DOCtalk with Dr. Gregg 11/25/14

November 24, 2014 News No Comments

MU: It Do and It Don’t

Dr. Robert Wachter recently wrote a wonderful piece that later posted on Healthcare IT News entitled Meaningful use: Born 2009 — died 2014? His subtitle was “I believe that meaningful use is now doing more harm than good,” a sentiment perhaps echoing through the barren halls of MU leadership as top echelon folks seem to be good at writing-on-the-wall reading.

It does seem that MU has gotten waylaid in processes and procedures, becoming less and less meaningful, and more useless than useful.

Did MU make a difference? You bet it did. If it doesn’t change its current course, will it continue to be of value? Doubtful, very doubtful.

Reflecting on its effects and impacts, here’s a few observations on the impact of MU, when “it do” help and when “it don’t.”


It Do:

  • Every time you see the notes from a consulting doc whose scribble used to be illegible, and whose notes are now clean and crisp in their Times New Roman or Arial font.
  • Whenever a lab result comes whistling into your EMR, directly from the lab, with values that are trended over time, and easy to view.
  • When pop up reminders help you catch a vaccine that might have been missed or remember a lab redraw that you didn’t want to forget.
  • When you want to hurry through your last few patients because it’s been a very long “one of those days” and your brilliant little EMR catches you in your tired rush before you prescribe an antibiotic to which a patient is allergic.
  • Each time a patient messages you through the portal and you realize how easy the portal makes it to communicate better with your patients, with less interruption to your daily flow (and with no phone tag!)
  • As your bank account receives a boost when the MU check clears after successfully meeting and attesting to your MU compliance.
  • When you want to know something about your practice, or your patients, and a relatively simple search reveals insights your paper chart system could never have supplied.


  • When you visit your otherwise very high-tech specialist who still uses paper charts and who swears that, after considering the negative impact on their currently comfortable workflow and running the ROI numbers, he thinks the penalties for MU avoidance are less bothersome than the expense of going digital.
  • As you want to contribute to electronic syndromic surveillance and are stymied by the inability of your state public health agencies for accepting such digital submissions.
  • Each time the fax machine rings and you receive another 87 pages of records transfer that you’d just love to have in digitally manageable form.
  • Indeed with every fax you receive as you realize that so little interoperability has been implemented that you still receive the vast majority of your patient-related communications from other providers the same way you did 20 years ago.
  • When you open your mail (snail-type) to read a consultant’s report that comes from a hospital-based specialist, part of a hospital system that you know for a fact uses Extormity, and yet here you are slicing open an envelope.
  • Whenever you decide to switch EHRs and realize that data migration standards and capabilities are less 2014-ish than they are 1995-ish.
  • When you receive a letter from CMS notifying you of an upcoming audit and you go online to read about some pretty nasty – and lengthy – provider MU audit experience nightmares.

Dr. Wachter has a line near the end of his post that reads: “Rather than continuing to push highly prescriptive standards that get in the way of innovation and consume most of the bandwidth of health IT vendors and delivery organizations, MU Stage 3 should focus on promoting interoperability, and little else.

Seems like a good prescription, doctor.

From the trenches…

“It do and it don’t.” – Barry Hunter, manager and trainer of dethroned boxing champ (steroid-related) Lamont Peterson

dr gregg

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).


Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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