The impact of stage 1 meaningful use on EHR adoption in early adopter small practice settings

The federal government proposed offering financial incentives to encourage healthcare providers to implement Electronic Health Records (EHR). The criteria by which those providers were judged in terms of whether they qualified for the incentive funding is known as meaningful use. The motivation for the federal incentives is to encourage recalcitrant providers to finally embrace adoption of EHRs. This study looks at the impact of meaningful use Stage 1 rules on those providers who had already adopted EHR prior to the advent of the meaningful use. The study involves a three round Delphi study involving providers and regional extension center (REC) staff that were hired by the federal government to support providers in their EHR adoption efforts. The data was collected through the use of email and online surveys. The goal of the initial survey was to identify the ways that Stage 1 meaningful use rules have impacted providers who were early adopters of EHR and who work in clinics or groups of less than 10 physicians. The initial survey included four categories of impact including financial, technical, social/cultural and procedural. The categories were high level constructs that appeared over and over in the literature review and were intended to ensure participants considered the range of potential impacts without unduly influencing their responses. The second survey included themes that appeared within the responses to the initial surveys with a pick list from which participants were asked to estimate the degree of impact of each item. The third and final survey consisted of a summary of the findings and a request that participants reply with any concerns or evidence that the findings were in any way in conflict with their experience. The results of the study are best described as benign with very little evidence that the impact of Stage 1 meaningful use on early adopters of EHR in small practice settings was significant. 100% of the participants chose to pursue the meaningful use incentive money. 100% were not required to replace their existing EHR systems as a requirement necessary to meet the meaningful use Stage 1 criteria.