{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:48:53Z","timestamp":1762102133811},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T00:00:00Z","timestamp":1516665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The federal meaningful use (MU) program was aimed at improving adoption and use of electronic health records, but practicing physicians have criticized it. This study was aimed at quantifying the benefits (ie, usefulness) and burdens (ie, workload) of the MU program for practicing family physicians.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>An interdisciplinary national panel of experts (physicians and engineers) identified the work associated with MU criteria during patient encounters. They conducted a national survey to assess each criterion\u2019s level of patient benefit and compliance burden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2015, 480 US family physicians responded to the survey. Their demographics were comparable to US norms. Eighteen of 31 MU criteria were perceived as useful for more than half of patient encounters, with 13 of those being useful for more than two-thirds. Thirteen criteria were useful for less than half of patient encounters. Four useful criteria were reported as having a high compliance burden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>There was high variability in physicians\u2019 perceived benefits and burdens of MU criteria. MU Stage 1 criteria, which are more related to basic\/routine care, were perceived as beneficial by most physicians. Stage 2 criteria, which are more related to complex and population care, were perceived as less beneficial and more burdensome to comply with.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>MU was discontinued, but the merit-based incentive payment system within the Medicare Access and CHIP Reauthorization Act of 2015 adopted its criteria. For many physicians, MU created a significant practice burden without clear benefits to patient care. This study suggests that policymakers should not assess MU in aggregate, but as individual criteria for open discussion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocx158","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T20:10:40Z","timestamp":1514319040000},"page":"694-701","source":"Crossref","is-referenced-by-count":8,"title":["Meaningful use\u2019s benefits and burdens for US family physicians"],"prefix":"10.1093","volume":"25","author":[{"given":"G Talley","family":"Holman","sequence":"first","affiliation":[{"name":"Center for Ergonomics, University of Louisville, Louisville, KY, USA"},{"name":"Department of Industrial Engineering, University of Louisville, Louisville, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven E","family":"Waldren","sequence":"additional","affiliation":[{"name":"Alliance for eHealth Innovation, American Academy of Family Physicians, Leawood, KS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W","family":"Beasley","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA"},{"name":"Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah J","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence D","family":"Dardick","sequence":"additional","affiliation":[{"name":"UCLA Health \u2013 Santa Monica Bay Physicians, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chester H","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Department of Biomedical Informatics, University of Buffalo, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Marquard","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Mullins","sequence":"additional","affiliation":[{"name":"Cerner Corporation, Kansas City, KS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles Q","family":"North","sequence":"additional","affiliation":[{"name":"Ambulatory Services and Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Rafalski","sequence":"additional","affiliation":[{"name":"Heart of Texas Community Health Center, Waco, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A Joy","family":"Rivera","sequence":"additional","affiliation":[{"name":"Knowledge and Systems Architect Team and Information Management Services, Children\u2019s Hospital of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tosha B","family":"Wetterneck","sequence":"additional","affiliation":[{"name":"Department of Medicine and Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA"},{"name":"Department of Industrial and Systems Engineering, and Center for Quality and Productivity Improvement, University of Wisconsin, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,1,23]]},"reference":[{"issue":"11","key":"2020110612372037900_ocx158-B1","first-page":"1","article-title":"Can computerized decision support systems deliver improved quality in primary care? Brit Med J","volume":"319","author":"Dalaney","journal-title":"1999"},{"key":"2020110612372037900_ocx158-B2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1370\/afm.1351","article-title":"Organizing care for complex patients in the patient-centered medical home","volume":"10(1)","author":"Rich","year":"2012","journal-title":"Ann Fam Med."},{"key":"2020110612372037900_ocx158-B3","volume-title":"Medical Expenditure Panel Survey Household Component Data \u2013 Table 1: Usual Source of Health Care and Selected Population Characteristics, United States 2008; Generated interactively","author":"Agency for Healthcare Research and Quality"},{"key":"2020110612372037900_ocx158-B4","first-page":"1386","article-title":"A discrete-event simulation application for clinics serving the poor","volume":"2","author":"Alexopoulos","year":"2001","journal-title":"Proceedings of the Institute of Industrial Engineering 2001 Winter Simulation Conference."},{"key":"2020110612372037900_ocx158-B5","doi-asserted-by":"crossref","first-page":"745","DOI":"10.3122\/jabfm.2011.06.100255","article-title":"Information chaos in primary care: implications for physician performance and patient safety","volume":"24","author":"Beasley","year":"2011","journal-title":"J Am Board Fam Med."},{"issue":"3","key":"2020110612372037900_ocx158-B6","first-page":"181","article-title":"Does health information technology dehumanize healthcare? AMA J of Ethics","volume":"13","author":"Bailey","journal-title":"2011"},{"issue":"17","key":"2020110612372037900_ocx158-B7","first-page":"1632","article-title":"What\u2019s keeping us so busy in primary care?","volume":"362","author":"Baron","year":"2010","journal-title":"a snapshot from one practice. N Engl J Med."},{"issue":"4","key":"2020110612372037900_ocx158-B8","first-page":"1","article-title":"Factors Affecting Physician Professional Satisfaction and their Implications for Patient Care, Health Systems, and Health Policy","volume":"3","author":"Friedberg","year":"2014","journal-title":"Rand Health Q."},{"key":"2020110612372037900_ocx158-B9","article-title":"Meaningful use doesn\u2019t benefit my patients","author":"McCrory","year":"2015","journal-title":"Phys Pract."},{"issue":"17","key":"2020110612372037900_ocx158-B10","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1056\/NEJMp1509961","article-title":"Transitional chaos or enduring harm?","volume":"373","author":"Rosenbaum","year":"2015","journal-title":"the EHR and the disruption of medicine. N Engl J Med."},{"key":"2020110612372037900_ocx158-B11","volume-title":"How to Attain Meaningful Use","author":"US Centers for Medicare and Medicaid (CMS)","year":"2015"},{"key":"2020110612372037900_ocx158-B12","volume-title":"Physicians Use of EHR Systems","author":"American EHR Partners","year":"2014"},{"issue":"7","key":"2020110612372037900_ocx158-B13","article-title":"Keeping meaningful use from becoming meaningless abuse: a cardiology\/ electrophysiology perspective","volume":"13","author":"Mitra","year":"2013","journal-title":"EP Lab Digest."},{"key":"2020110612372037900_ocx158-B14","volume-title":"Meaningful Use. Born, 2009, Died, 2014?","author":"Watcher","year":"2014"},{"key":"2020110612372037900_ocx158-B15","volume-title":"25 Quotes that Show Just How Fed Up Physicians Are with EHRs","author":"Green","year":"2016"},{"key":"2020110612372037900_ocx158-B16","article-title":"American Medical Association CEO: beware of poor-quality digital \u201cadvancements.\u201d","author":"Davis","year":"2016","journal-title":"Healthcare IT News"},{"key":"2020110612372037900_ocx158-B17","doi-asserted-by":"crossref","DOI":"10.1177\/2327857916051012","article-title":"Using challenges associated meaningful-use criteria to prioritize needed changes in electronic health records","volume-title":"Proceedings of Human Factors and Ergonomics Society International Health Care Symposium","author":"Holman","year":"2016"},{"key":"2020110612372037900_ocx158-B18","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3122\/jabfm.2015.03.150097","article-title":"Electronic health record innovations for healthier patients and happier doctors","volume":"28(3)","author":"Krist","year":"2015","journal-title":"J Am Board Fam Med."},{"issue":"5","key":"2020110612372037900_ocx158-B19","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1136\/amiajnl-2013-002229","article-title":"Electronic health record functionality needed to better support primary care","volume":"21","author":"Krist","year":"2014","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612372037900_ocx158-B20","doi-asserted-by":"crossref","first-page":"727","DOI":"10.7326\/M13-2589","article-title":"Electronic health records: design, implementation and policy for higher value primary care","volume":"160(10)","author":"Sinsky","year":"2014","journal-title":"Ann Int Med."},{"key":"2020110612372037900_ocx158-B21","volume-title":"Physician Characteristics and Distribution in the US","author":"American Medical Association","year":"2015"},{"key":"2020110612372037900_ocx158-B22","volume-title":"Annual Census Report","author":"American Academy of Family Physicians","year":"2016"},{"issue":"2","key":"2020110612372037900_ocx158-B23","first-page":"30","article-title":"The problem list beyond meaningful use: part I: the problems of the problem list","volume":"82","author":"Holmes","year":"2011","journal-title":"J AHIMA."},{"key":"2020110612372037900_ocx158-B24","first-page":"311","article-title":"The accuracy of recording patient problems in family practice","volume":"51(4)","author":"Bensten","year":"1976","journal-title":"Acad Med."},{"key":"2020110612372037900_ocx158-B25","first-page":"285","article-title":"Strategies for problem list implementation in a complex clinical enterprise","volume-title":"Proceedings of the AMIA Symposium","author":"Campbell"},{"key":"2020110612372037900_ocx158-B26","volume-title":"Standardizing the Problem List in the Ambulatory Electronic Record to Improve Patient Care","author":"Hummel","year":"2012"},{"issue":"4","key":"2020110612372037900_ocx158-B27","first-page":"34","article-title":"Creating a lean practice","volume":"13","author":"Endsley","year":"2006","journal-title":"Fam Pract Manag."},{"key":"2020110612372037900_ocx158-B28","first-page":"1","article-title":"The myth of workflow in the primary care","volume":"107","author":"Holman","year":"2015","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612372037900_ocx158-B29","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1370\/afm.1713","article-title":"From the triple to quadruple aim: care of the patient requires care of the provider","volume":"12(6)","author":"Bodenheimer","year":"2014","journal-title":"Ann Fam Med."},{"key":"2020110612372037900_ocx158-B30","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/MLR.0000000000000331","article-title":"Patient-centered medical home capability and clinical performance in HRSA-supported health centers","volume":"53","author":"Shi","year":"2015","journal-title":"Med Care."},{"issue":"5","key":"2020110612372037900_ocx158-B31","first-page":"e43","article-title":"Lean implementation in primary care health visiting services in National Health Service UK","volume":"19","author":"Grove","year":"2010","journal-title":"Qual Safety Health Care."},{"key":"2020110612372037900_ocx158-B32","article-title":"The uncertain future of meaningful use","author":"Waldren","year":"2015","journal-title":"AAFP News"},{"issue":"12","key":"2020110612372037900_ocx158-B33","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.mayocp.2015.08.023","article-title":"Changes in burnout and satisfaction with work-life balance in physicians and the General US Working Population Between 2011 and 2014","volume":"90","author":"Shanafelt","year":"2015","journal-title":"Mayo Clinic Proc."},{"key":"2020110612372037900_ocx158-B34","doi-asserted-by":"crossref","first-page":"i50","DOI":"10.1136\/qshc.2005.015842","article-title":"Work system design for patient safety: the SEIPS model","volume":"15","author":"Carayon","year":"2006","journal-title":"Qual Saf Health Care."},{"key":"2020110612372037900_ocx158-B35","doi-asserted-by":"crossref","first-page":"i59","DOI":"10.1136\/qshc.2005.015974","article-title":"A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional","volume":"15","author":"Karsh","year":"2006","journal-title":"Qual Saf Health Care."},{"key":"2020110612372037900_ocx158-B36","doi-asserted-by":"crossref","first-page":"i68","DOI":"10.1136\/qshc.2010.042085","article-title":"A new sociotechnical model for studying health information technology in complex adaptive healthcare system","volume":"19","author":"Stig","year":"2010","journal-title":"Qual Saf Health Care."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/25\/6\/694\/34150706\/ocx158.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/25\/6\/694\/34150706\/ocx158.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T17:48:51Z","timestamp":1604684931000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/25\/6\/694\/4822520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,23]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,1,23]]},"published-print":{"date-parts":[[2018,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocx158","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,6]]},"published":{"date-parts":[[2018,1,23]]}}}