The Lesson Of Meaningful Use: Selling Doctors On Electronic Records

It seems like a no brainer.  Moving from paper-based medical charts to electronic health records (EHRs) will go a long way to improving the quality and reducing the costs of health care in the US. But it’s it been a tough sell, with only about 20% of doctors using even basic EHRs today. To move things along, the American Recovery and Reinvestment Act included an incentive program for doctors and hospitals that move to EHRs. As the world’s biggest health insurer, Medicare & Medicaid hope to net huge savings over the next decade if they can bring the health sector into the digital era.

DrFrank This isn’t the first time that insurers have tried to promote EHRs.  Grant programs were established in nearly every state to help underwrite the costs of the technology, especially to small physician groups that are the least able to make these sorts of investments.  In California, Wellpoint made $50 million available to doctors to offset the cost of buying computers and systems for their offices.  So what happened?  Health care providers bought systems, got their rebates, encountered their first hurdle in using their new systems, and went back to their old paper ways.

The recent federal incentive program will fare better because it doesn’t reward procurement or even deployment of an EHR — it rewards adoption, or what the regulations call “meaningful use.”  For a hospital to qualify for the millions of dollars in incentive payments it could get over the next few years, it has to demonstrate certain organizational behaviors:  Electronically transmit at least 75% of all prescriptions — not simply own an ePrescribing app.  Capture at least 50% of all clinical lab results as structured patient data — not just integrate with lab systems.  The point is, these incentives will only yield good outcomes if the technology gets ADOPTED.

So what does a sales person sell? They have a product — an electronic health records application with all the bells and whistles plus specialty modules for gastroenterology — but the buyer at a hospital isn’t just concerned about installing a product. In fact, their problem isn’t having an EHR, it’s getting the doctors to use the EHR. The vendors have gotten the message, made even more clear in the recent mandate for “meaningful use,” that they have to solve the problem from the buyer’s perspective and so have added change management services, online training, real-time help, and on-boarding programs to complement their products.  In a market where capabilities are at near parity, user experience and adoption have become the new “products.” 

The idea of “meaningful use” resonates outside of health care as well. Companies buy BI tools that business analysts don’t use.  They pay for feature enhancements that users don’t see or use.  They deploy new ways to collaborate that people can’t figure out how to operate.  They’re not getting the outcomes they expect, and it reflects badly on you and your company.  What’s the lesson to be learned from the health care incentives program ?  You (and your sales force) have to know what customers need to do to solve their problems and get good outcomes.  Hint:  the doctor asks, “Where does it hurt?”