Recent Study Finds No Association Between MU And Quality Of Care

By Christine Kern, contributing writer

JAMA study shows Meaningful Use does not automatically mean improved care

Despite the fact that the Meaningful Use program is designed in large part to improve the quality of patient care, a new study published in JAMA Internal Medicine found there is no clear or apparent association between a “meaningful user” of electronic health records and improved quality of patient care.

According to FierceEMR, researchers examined how Brigham and Women's Hospital and affiliated ambulatory practices treated outpatients during a 90-day reporting period in 2012 in order to ascertain whether quality improvements could be identified on seven measures for five chronic diseases: hypertension, diabetes mellitus, coronary artery disease, asthma, and depression. All of the physicians used the same advanced EHR.

While 63 percent of the 858 physicians assessed were “meaningful users” of their EHRs, the study found no association between attaining Meaningful Use and quality. The results demonstrated “marginally” better results for MU with diabetes and hypertension, marginally worse for asthma and depression, and constant for the other categories.

Researchers noted that the study raises questions about how to measure MU. In a commentary accompanying the study, it was noted assessments are affected by a number of variables, including duration and setting of EHR use, reliability of electronic reporting of quality measures, and methods of EHR use by physicians to make clinical decisions.

The commentary also asserted that "EHRs appear to be associated with a higher quality of care, but it is not known whether achieving MU per se will result in greater quality gains than adoption of EHRs without achieving MU."

This is not the first time that the connection between MU measures and quality of patient care has been questioned. Recently, The General Accountability Office warned that the program's clinical quality measures were "unreliable."

HealthDataManagement also reported that in an April 8 Health IT Policy Committee meeting Jennifer King, acting director of the office of economic analysis, evaluation and modeling in the Office of the National Coordinator for Health IT, reported critical access hospitals and small urban hospitals have been less likely to attest to Stage 1 meaningful use EHR than small rural hospitals, medium-sized hospitals, and large hospitals. Nevertheless, King said the "widespread adoption of meaningful use" is improving healthcare delivery and outcomes.