More Meaningful Use Misery from One Doc

March 29, 2016

Meaningful Use continues to be a pain in the neck for one doctor, who is struggling to attest as a private practice physician.

When I last wrote of the trials and tribulations of Meaningful Use, I had just failed to attest due to inadequate numbers for "prescription eligibility verification," "electronic summaries of care," and "viewing document images rather than reports."  That was in January 2015, after I had worked and massaged my 2014 information for three months in order to attest successfully.

My EHR vendor maintains a Meaningful Use dashboard, and by July of last year, I could see that in the new Stage 2 measures for 2015, physicians no longer had to include the prescription verification or images.  After that, I then entered the "LOOP OF DEATH," in which multiple attempts to enter the system were met by the same message that my user name and/or password were not correct.  Many password changes later, I was still unsuccessful.  All the while, the system was closed for submission while the new measures were being discussed [by regulators].  I subsequently found by talking to a real person (after 40 minutes on hold), that my difficulties in registration had been due to entering my name as Georgia, rather than georgia.  To enter the CMS Enterprise system, Georgia worked fine, but for Meaningful Use, font case mattered. I will not belabor my difficulties with the enterprise system attempting to view my 2014 Physician Quality Reporting System (PQRS) data, except to say that my office manager and I have EACH spent more than three hours trying to penetrate the obfuscation and obtain my Provider Transaction Access Number (PTAN) number, without which, no data is forthcoming. We are still waiting.

On the positive side, I successfully attested in January 2016 for the last 90 days of 2015.  Only private physicians struggling with this mess can truly appreciate the work involved.  Employed physicians usually have behind the scenes people who are working on it for them.

This year, 2016, the attestation period is the entire year. I could do nothing and report on the same measures, just for a longer period.  However, in the interim, I have joined an Accountable Care Organization (ACO). I am still a solo physician, affiliated with the mother organization, but not employed.  We’re now talking about reporting on quality to CMS and rather than using Meaningful Use measures, we have selected several additional, different measures.  We may also be reporting on various Healthcare Effectiveness Data and Information Set (HEDIS) measures, as well as continuing to report on PQRS. I have argued, in vain, that we need to select measures that are THE SAME for all of these entities, but the people in charge, who have obviously not struggled with Meaningful Use at all, haven't listened.  Again, as a solo physician without IT support, I have to figure out how to incorporate all of this, so that the system will report it.

I, for one, cannot WAIT until we have a single payer system, with  per member, per month payment based on acuity, age, etc. and with clearly defined quality metrics, embedded in our EHRs.  The current system is a mess. Of course, if the single payer system is CMS, we are screwed.