Health Affairs

From Health Affairs

'Meaningful Use' And Electronic Health Records: Real Results Won’t Show Till Later

Bethesda, MD -- A new study, to be released online today as a Web First by Health Affairs, examined the potential impact on Medicare and Medicaid patients of the current (stage 1) “meaningful use” standards for health information technology. It found that the stage 1 threshold for hospitals and health providers to demonstrate “meaningful use” of electronic medication order entry and qualify for bonus payments through Medicare and Medicaid is unlikely to have a significant impact on hospital mortality rates among Medicare patients. This is the first study to evaluate the relationship between the “meaningful use” standards for computerized medication ordering and hospital mortality rates. As part of the American Recovery and Reinvestment Act of 2009, the federal government is offering bonus payments through Medicare and Medicaid to hospitals and other health providers who meet new standards for “meaningful use” of health information technology.

Today’s ‘Meaningful Use’ Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More By Spencer S. Jones, Paul Heaton, Mark W. Friedberg, and Eric C. Schneider http://content.healthaffairs.org/content/early/2011/09/12/hlthaff.2011.0245.abstract The authors are all with the RAND Corporation. Friedberg and Schneider are also affiliated with Harvard Medical School, and Schneider also holds a position at the Harvard School of Public Health. This study will also appear in the October issue of Health Affairs.

The authors assessed the mortality rates of patients within thirty days of being hospitalized for heart attacks, heart failure, or pneumonia, obtaining mortality data from the September 2008 release of the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database. They used data on hospital characteristics from the 2007 American Hospital Annual Survey database, analyzing the 4,644 general acute care hospitals in the United States not owned by the federal government. To obtain information about hospitals’ use of electronic medication ordering, the authors relied on the 2007 American Hospital Association Information Technology Supplement. In comparing mortality rates among hospitals reporting different levels of use for electronic medication order entry, they found a statistically significant relationship with heart attack and heart failure but not with pneumonia. Also, higher levels of use—with more than 50 percent of patients—were more consistently associated with lower mortality for both heart attack and heart failure. Policy makers are now debating what stage 2 standards should be and when they should be implemented. This study’s findings indicate that greatly increased use of electronic medication order entry has the potential to reduce mortality in the future. Conclude the authors: “Our study may reassure policy makers and other stakeholders that high levels of use of computerized provider order entry and other health information technology have value and may yield tangible health benefits for patients.”

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at www.healthaffairs.org. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

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