title: Meaningful Use of Electronic Health Records: Experiences From the Field and Future Opportunities.
abstract: BACKGROUND
  With the aim of improving health care processes through health information technology (HIT), the US government has promulgated requirements for "meaningful use" (MU) of electronic health records (EHRs) as a condition for providers receiving financial incentives for the adoption and use of these systems. Considerable uncertainty remains about the impact of these requirements on the effective application of EHR systems.
  
  
  OBJECTIVE
  The Agency for Healthcare Research and Quality (AHRQ)-sponsored Centers for Education and Research in Therapeutics (CERTs) critically examined the impact of the MU policy relating to the use of medications and jointly developed recommendations to help inform future HIT policy.
  
  
  METHODS
  We gathered perspectives from a wide range of stakeholders (N=35) who had experience with MU requirements, including academicians, practitioners, and policy makers from different health care organizations including and beyond the CERTs. Specific issues and recommendations were discussed and agreed on as a group.
  
  
  RESULTS
  Stakeholders' knowledge and experiences from implementing MU requirements fell into 6 domains: (1) accuracy of medication lists and medication reconciliation, (2) problem list accuracy and the shift in HIT priorities, (3) accuracy of allergy lists and allergy-related standards development, (4) support of safer and effective prescribing for children, (5) considerations for rural communities, and (6) general issues with achieving MU. Standards are needed to better facilitate the exchange of data elements between health care settings. Several organizations felt that their preoccupation with fulfilling MU requirements stifled innovation. Greater emphasis should be placed on local HIT configurations that better address population health care needs.
  
  
  CONCLUSIONS
  Although MU has stimulated adoption of EHRs, its effects on quality and safety remain uncertain. Stakeholders felt that MU requirements should be more flexible and recognize that integrated models may achieve information-sharing goals in alternate ways. Future certification rules and requirements should enhance EHR functionalities critical for safer prescribing of medications in children.
authors.affiliation: Division of Pharmacy, School of Medicine Pharmacy and Health, Durham University, Durham, United Kingdom.
authors.forename: Sarah Patricia
authors.identifier: http://orcid.org/0000-0002-0339-846X
authors.initials: SP
authors.lastname: Slight
authors.forename: Eta S
authors.identifier: http://orcid.org/0000-0003-4319-2949
authors.initials: ES
authors.lastname: Berner
authors.forename: William
authors.identifier: http://orcid.org/0000-0001-7811-5391
authors.initials: W
authors.lastname: Galanter
authors.forename: Stanley
authors.identifier: http://orcid.org/0000-0001-8595-2665
authors.initials: S
authors.lastname: Huff
authors.forename: Bruce L
authors.identifier: http://orcid.org/0000-0002-5557-0831
authors.initials: BL
authors.lastname: Lambert
authors.forename: Carole
authors.identifier: http://orcid.org/0000-0002-8049-7998
authors.initials: C
authors.lastname: Lannon
authors.forename: Christoph U
authors.identifier: http://orcid.org/0000-0001-9559-4646
authors.initials: CU
authors.lastname: Lehmann
authors.forename: Brian J
authors.identifier: http://orcid.org/0000-0002-5757-3024
authors.initials: BJ
authors.lastname: McCourt
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0003-4813-8845
authors.initials: M
authors.lastname: McNamara
authors.forename: Nir
authors.identifier: http://orcid.org/0000-0002-3411-2700
authors.initials: N
authors.lastname: Menachemi
authors.forename: Thomas H
authors.identifier: http://orcid.org/0000-0002-3416-5474
authors.initials: TH
authors.lastname: Payne
authors.forename: S Andrew
authors.identifier: http://orcid.org/0000-0002-0085-6525
authors.initials: SA
authors.lastname: Spooner
authors.forename: Gordon D
authors.identifier: http://orcid.org/0000-0002-2821-3994
authors.initials: GD
authors.lastname: Schiff
authors.forename: Tracy Y
authors.identifier: http://orcid.org/0000-0002-3318-3777
authors.initials: TY
authors.lastname: Wang
authors.forename: Ayse
authors.identifier: http://orcid.org/0000-0002-8624-5038
authors.initials: A
authors.lastname: Akincigil
authors.forename: Stephen
authors.identifier: http://orcid.org/0000-0003-0366-7583
authors.initials: S
authors.lastname: Crystal
authors.forename: Stephen P
authors.identifier: http://orcid.org/0000-0002-1327-9341
authors.initials: SP
authors.lastname: Fortmann
authors.forename: David W
authors.identifier: http://orcid.org/0000-0001-6268-1540
authors.initials: DW
authors.lastname: Bates
keywords: electronic health records; health policy; meaningful use; medical informatics