Are meaningful use bonuses enough to drive EMR adoption?

If a health system made up of accountable, coordinated, patient-centered care is to be achieved in the U.S., the existing information technology infrastructure is not enough to get the country there, according to a report by the Bipartisan Policy Center.

The center's Task Force on Delivery System Reform and Health IT found that although meaningful use and the technological gains made because of it are a strong foundation to a reformed health care system, changes are needed in the way physicians and patients view information sharing and exchange -- and in the way the government and payers align incentives.

The Bipartisan Policy Committee is a Washington-based public policy research and advocacy group founded by former Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole and George Mitchell. Its report was released Jan. 27.

Meaningful use incentives have been credited for the accomplishments made in health IT investments and implementation. With the help of incentive pay to hospitals and physician practices that meet meaningful use standards for EMR systems, widespread adoption of health IT is coming closer to reality. Evidence of this came from a November 2011 report by the National Center for Health Statistics, which found that 57% of office-based physicians use an EMR, and 52% said they planned to apply for meaningful use incentive money, up from 41% in 2010.

But Janet Marchibroda, the health IT initiative chair for the Bipartisan Policy Center, said meaningful use isn't enough. Patient data need to be more transferable from system to system and from system to patients, who need to take a more active role in how their health care information is handled. She said many physicians not only lack the technical ability to achieve data exchange, they also lack the incentive.

Marchibroda said she hopes that the delay of stage 2 of meaningful use until 2014 will allow more time for the needed health information exchange infrastructure to be built so that existing gaps can be bridged. "If you look at stage 1 around the requirements for health information exchange, they are pretty minimal. And the reason for that is ... we didn't have the infrastructure to support exchange, so we couldn't get there."