DQ 2 : Identify two to three indications that meaningful use has improved care coordination

Take the second question first, because the priorities explain what the indications should be looking for. Meaningful use was built in stages on a small set of policy priorities: improving quality, safety and efficiency while reducing health disparities; engaging patients and families; improving care coordination; improving population and public health; and maintaining privacy and security. The programme's method was to pay clinicians and hospitals for demonstrating specific uses of certified electronic records rather than for owning them, which is why the objectives are worded as measurable behaviours — producing a summary of care record at transitions, exchanging it electronically, reconciling medications, providing patients electronic access. Saying that the incentive was attached to use rather than adoption is the sentence that shows you understand the design. The objectives are worded as behaviours precisely so that they could be attested to and audited.Paying for demonstrated use rather than for ownership is the design decision that shaped every objective.

Now the indications, and hold them to being evidence. Defensible ones: adoption of certified records moved from a minority of hospitals to near-universal within a decade, which is a precondition for any electronic coordination at all; electronic summary-of-care exchange at transitions rose substantially where before it was fax or nothing; electronic medication reconciliation at admission became routine; and patient access through portals became a standard expectation rather than an innovation. Then be honest about the mixed picture, because it is the more interesting half. Interoperability between different vendors lagged far behind adoption, so a record was often electronic and still not shareable. Documentation burden rose and is now firmly associated with clinician burnout. And several studies found attestation to the objectives without a corresponding change in outcomes, which is the classic result when a measure becomes a target. Say which of your indications is strongest and why.