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.

Purpose

The authors wanted to look what were the barriers and obstacles faced with maintaining a EHR within a low resource practice. They also wanted to assess the challenges with maintaining and using a health IT system.

Methods

The authors used a qualitative observational study. They conducted interviews and observations of the implementation process. Cognitive task analysis interviews were also conducted. Some of the interviews were conducted with implementation specialists to identify any reoccurring issues.

Results

The study showed that smaller practices particularly in rural primary practices do not have the resources to support a meaningful use system.

Conclusions

For those practices without affiliation to maintain the necessary expert staff, ongoing support will be necessary for those practices to remain viable.

Comments

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.