Sustaining "Meaningful Use" of Health Information Technology in Low-Resource Practices
Meaningful use is a Medicare/Medicaid program that was started in 2009 through the HITECH act. Through this program hospitals and eligible providers could demonstrate their utilization of an electronic health technology and meet certain criteria to receive financial incentives. The requirements were demonstrated through the use of an electronic health record. To receive any of the financial incentives physicians needed to show meaningful use of the electronic health record by documenting patient data and meeting requirements through measures and objectives. There have been many studies conducted on the implementation of EHRs but not enough research has been done on the maintenance of the health IT systems. Health IT systems require updates, changes in formatting, and additional training. Maintenance of a health IT system requires information technology expertise and support. These technical resources and support are hard to come by with low resource primary care practices.
The authors wanted to look what were the barriers and obstacles faced with maintaining a EHR within a low resource practice. They focused on practices that had very little or no internal IT support. This could be due to lack of resources or finances. Many times rural areas do not have the expertise of an internal IT support like a big organization would have. The authors also wanted to assess the challenges that these practices faced with maintaining and using a health IT system.
The authors used a qualitative observational study. They conducted interviews and observations of the implementation process. the authors interviewed implementation specialists that would assist these types of practices in rural or urban areas.Cognitive task analysis interviews were also conducted. Some of the interviews were conducted with implementation specialists to identify any reoccurring issues.
The study showed that smaller practices particularly in rural primary practices do not have the resources to support a meaningful use system. Many times these smaller practices did not have the background knowledge of meaningful use and the requirements for documentation. The authors did find that rural practices did not have any internal technology support to assist them with any upgrades or maintenance of their EHR. The rural practices could not support any education to handle any changes with the system after the implementation. Another issue faced is the unreliability of internet services to the practice.
There is a need for a long term solution to assist and support these smaller rural urban practices to be successful with a health IT system. If the support is not available the quality of patient care to these areas will decrease or be non-existent. For those practices without affiliation to maintain the necessary expert staff, ongoing support will be necessary for those practices to remain viable.
This study brought emphasis to the need for financial aid and IT support to physicians practicing in rural areas. Without ongoing financial support or access to technical experts many rural practices will not survive. These practices are needed to support those that live to far from big healthcare organizations. Without the aid and financial support to IT experts these smaller practices will not survive.
- Sustaining Meaningful Use of Health Technology in Low Resource Practices.http://www.annfammed.org/content/13/1/17