While the physician community may still be split on the overall clinical viability of Meaningful Use, there is no doubting that the U.S. Centers for Medicare and Medicaid Services' push for greater electronic health record adoption has achieved one of its primary goals. According to a 2014 press release from the Department of Health and Human Services, 78 percent of all office-based physicians currently use at least one EHR system in their daily workflows, and 59 percent of all hospital-based physicians do the same. Both figures represent staggering increases compared to mere years prior, which bodes well for the future of an interconnected health IT ecosystem.

However, evidence is beginning to emerge that the time individual providers decided to throw their lots in with MU has had some impact on their ability to deliver high-quality clinical care. According to a recent study conducted by researchers at Weill Cornell Medical College and published in the journal Health Affairs, "systematic differences" are beginning to emerge between providers who signed on to MU early in the program's initial stages and those who chose to go their own ways. This "digital divide," while seemingly innocuous, could threaten the future of interoperable health IT.

Providers who jumped onto the MU bandwagon are reaping dividends.Providers who jumped onto the MU bandwagon are reaping dividends.

What is the 'digital divide'?
While MU was originally conceived of as a way to both mandate the use of a technology many saw as the future of healthcare and help providers otherwise lost in the weeds to hit concrete benchmarks to prove performance and qualify for incentive payments, Hye-Young Jung, Ph.D., assistant professor of health care policy and research at Weill Cornell and lead author of the study, believes that the disparity in MU adopters has caused an inadvertent split in clinical capabilities.

By investigating more than 26,000 physicians practicing in New York and cross-referencing their medical interventions with payment information from the first two years of MU in 2011 and 2012, Jung found that early participants demonstrated greater finances, more advanced health IT usage and greater capacities to adapt to changes in the health IT field.

"Those physicians who adopted the program may provide higher quality care to their patients," Jung said in a statement, as quoted by Healthcare IT News. "This difference may create a digital divide."

Jung indicated that though waiting to participate in MU until later stages may have made financial or administrative sense for individual providers at the time, the entire nation relies on providers to operate at similar levels of health IT functionality. When only some providers achieve high-level IT usage, their benefits are roughly isolated, as the effects are interoperability can only be exercised in this small circle or for a pittance of patients.

"Providers that did not jump onto the MU bandwagon early are in danger of being left behind permanently."

Closing the gap
Joshua Vest, Ph.D., assistant professor of healthcare policy and research and contributing author of the study, explained that those who did not jump onto the MU bandwagon early are in danger of being left behind permanently – an untenable result in the healthcare industry.

"The expectation is that physicians and hospitals should be electronic," Vest said in a statement, as quoted by Healthcare IT News. "How would everybody feel if only half of the banks were electronic nowadays? Without additional support to move forward, there is the potential to stall out among those who do not have the resources or capability to adopt EHRs."

While providers who took their time embracing the principles of the MU program may suddenly find themselves behind the eight ball, so to speak, it is certainly not too late to make up the ground on their competitors. Years removed from the start of MU, not only has the program advanced, but so too have the technologies that made possible the advances early adopters now enjoy. Through health IT innovations such as cloud-based EHRs and software with secure direct messaging options, providers still operating off primarily paper-based record keeping can quickly and efficiently bring themselves into the 21st century of healthcare IT.