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It's always interesting when the government tries to force adoption of anything on us. As in the case with the Electronic Medical Record (EMR) for physicians, the carrot has been placed in front of the physician community in the form of incentive payments for adoption of an EMR in their practices. The early adopters will be rewarded with higher incentive payments while the late adopters will receive lower incentive payments. In addition, as with all carrots, there comes a stick in the form of financial penalties that are applied to the procrastinator physician's fee schedule starting in 2015.

The measurement that the government uses to determine "effectiveness" of an EMR is through defined criteria covering its use. These criteria are called "meaningful use guidelines" and they cover twentyfour key areas within a practice. A physician and the selected EMR must meet the "meaningful use" criteria in order to receive incentive compensation under the HITECH Act, a component of the American Recovery and Reinvestment Act (ARRA). There is debate over what constitutes "meaningful use" within the physician community however. There are different interpretations of how meaningful use has been applied in the development of the EMR. Some EMR functionality serves the "meaningful use" criteria but not all the criteria meet the functionality for the clinicians that use it.

As with a physician or practice manager starting the journey of selecting an EMR, let's take a look at each of the "meaningful use" criteria and apply some practical guidance to it to help decide how "meaningful" the EMR is to the end user, the physician and their staff.