Meaningful Use: What Flo Knows

The term "meaningful use" describes the way health information technology should be put to work to improve population health, individual health, and system efficiency. Stakeholders have been aTwitter (search #MU) because IT applications/solutions that meet "meaningful use" criteria will be able to snag a piece of the $20 billion ARRA monies.

If you're new to how the delivery of health care impacts outcomes, you can join those of us who have been screaming and clawing our faces for some time by perusing these dismal stats:

• 2009 estimates of infant mortality rates (considered a reliable indicator of the level of health in a country) show the US at 6.26/1,000, behind Sweden's 2.75/1,000, Germany's 3.99/1,000, and the U.K.'s 4.85/1,000. (We're 2 notches up from Croatia, which posts 6.32/1,000)


• For every $1 spent on health in the US, our G-5 competitors spend $0.63

Meaningful use should not define health IT. It should define what health IT enables: meaningful use of information technology to achieve desirable outcomes. This is what IT has done for every other sector of the economy, including the Amish micro-economy, in which people--who are as-off-the-grid as you can get--manage their agriculture and cabinet-making businesses (albeit with generator-powered computers).

If the Amish comparison is too far out for you, here's what Ivan Seidenberg, Chairman and CEO of Verizon Communication, said in the The Business Roundtable Health Care Value Comparability Study, published earlier this year:

"When it comes to scientific advances, medical technology and the quality of our doctors and hospitals, the American system is robust. But health care is beyond the reach of an increasing number of Americans. From our perspective, the problem with the U.S. health care market is that it doesn’t really function as a market – it leaves major consumer needs unmet, costs unchecked by competition and basic practices untouched by the productivity revolution that has transformed every other sector of the economy." (emphasis mine)

I've got to believe that the productivity deficit Seidenberg calls out has something to do with how IT works (or doesn't) to achieve operational efficiencies. IT doesn't move us toward a healthcare whole although it's certainly been harnessed to great benefit for individuals lucky enough to be able to access high-end care (just ask me or any other parent who talks to their cochlear-implanted kids on a cellphone).

When patients seek care or healthcare workers go to work, IT doesn't show up in the ways we've become accustomed to. Oh, it works in the piecemeal, "best of breed" way that we've asked it to, supporting the piecemeal "best of breed" health system we've concocted. But IT, as currently designed and implemented, is wholly insufficient for the complex tasks-at-hand.

Yesterday, a preliminary report from the Health IT Meaningful Use Workgroup was made public. Not everyone is happy. And there may be opportunity to improve on the first stab. But so far, I've found the preliminary Meaningful Use materials to be true to the IOM's Six Dimensions of Care, elements seen as the backbone of a healthy health care system.

Safe, effective, timely, efficient, patient-centered, and equitable. The Big 6, first defined in Crossing the Quality Chasm, the road map to healthcare improvement we've been asked to follow for the past 8 years. Only now, we may have meaningful IT vehicles to help take us there.