Meaningful Use and Beyond. A Guide for IT Staff in Health Care

Fred Trotter, David Uhlman

Published by






Reviewed by

Sheila Bullas MBCS CITP


8 out of 10

‘Meaningful Use’ is the name of a national health IT programme in the US: one that requires the use of systems and measures submitted to government. It describes a series of steps towards realisation of the long-term potential of IT in health care.

The term first appeared in the American Recovery and Reinvestment Act (2009) - money would be provided based on meeting criteria for the ‘meaningful use’ of electronic health records, electronic patient records and similar systems.

This book is aimed primarily at US informaticians, but don’t let this put you off. Many of the issues are the same whether US, UK or elsewhere: poor take-up by hospitals, complex system in constant change, poor incentives for take-up and few penalties for not.

The VA and Kaiser Permanente in the US are good examples where these issues have been resolved. The differences are sufficient to mean that this book is probably not suitable for someone who is new to the UK health system.

There is an excellent chapter considering the relative advantages and disadvantages of  paper and software in the clinical setting and the argument for paired clinician and technologist working. Patient-focussed software, consumer-oriented devices and patients’ use of social media are also relevant.

Human error accounts for an estimated 40k to 200k deaths per year in the US and system and process errors add to this. The situation is little different in the UK. There is good discussion of how IS can reduce risk, but also how it introduces its own risks.

Ontologies or coding systems are crucial to any EHR. The principles and the problems are discussed. It should be remembered that there are some significant differences in the coding systems and standards used in the UK. This also applies to the chapter on Interoperability.

The chapters on Meaningful Use, the HIPAA regulation (Health insurance portability and accountability act) and Medical Billing are specific to the US, although they give insights into incentives for system use in particular.

Meaningful Use and Beyond is well written, readable and provides a good understanding of the current position of US health informatics.

Further information: O'Reilly

January 2012