'Meaningful use'–by patients?

In the US, primary care physicians, providers and policy wonks are currently mulling achieving the standards set for ‘meaningful use’ of EMRs by CMS (Centers for Medicare and Medicaid Services). Dr. Joseph Kvedar of the Center for Connected Health in Boston writes on the inherent ‘double standard’–that 41% of phase I criteria of physician performance will have heavy reliance on patient behaviors, yet there is little or no attention paid [or incentive, or assistance given–Ed.] on patient accountability. He leans rather heavily on this last point for the usual chronic diseases, which by and large are due to or precipitated by unhealthy behaviors/lifestyle.  It’s a point well taken.  Yet read the first comment below from a long-term asthma sufferer–a situation where the outcome, despite compliance, worsened due to medication side effects.  Is this person accountable for what happened in being compliant with what had been standard treatment? Other examples: accidents, congenital conditions, drug interactions, infections, surgeries gone sideways and other circumstances can lead to chronic conditions months or even years later.  A thought-provoking article, followed by some fairly strong comments [Ed. update 30 April]Connected Health and Meaningful Use