Feds define ‘meaningful use' of health IT

Physicians hoping to qualify for up to $44,000 in federal funds for implementing an EHR should take note of the meaningful-use criteria approved July 16 by the Office of the National Coordinator for Health Information Technology's Health IT Policy Committee. The group's recommendations will be incorporated into a final rule from the Centers for Medicare & Medicaid Services due Jan. 1, 2010. Although not yet final, the recently released criteria give physicians a better sense of what their EHR systems will need to be able to do come 2011.

The year-one meaningful-use criteria for physicians (hospitals have separate criteria) fall under five areas and include the following:

Improving quality, safety and efficiency and reducing health disparities

• Use computerized entry for all orders (medication, laboratory, procedure, diagnostic imaging, immunization, referral) although electronic interfaces to receiving entities are not required in 2011
• Implement drug-drug, drug-allergy and drug-formulary checks
• Maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED
• Generate and transmit permissible prescriptions electronically
• Maintain active medication list and medication allergy list
• Record demographics (preferred language, insurance type, gender, race and ethnicity)
• Record advance directives
• Record vital signs (height, weight, blood pressure, BMI) and smoking status
• Incorporate lab-test results into EHR as structured data
• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach
• Report ambulatory quality measures to CMS
• Send reminders to patients per patient preference for preventive/follow-up care
• Implement on decision rule relevant to specialty or high clinical priority
• Document a progress note for each encounter
• Check insurance eligibility electronically from public and private payers, where possible
• Submit claims electronically to public and private payers

Engaging patients and families

• Provide patients with an electronic copy of or electronic access to their health information (including lab results, problem list, medication lists, allergies) upon request
• Provide access to patient-specific educational resources
• Provide clinical summaries for patients for each encounter

Improving care coordination

• Electronically exchange key clinical information (e.g., problem list, medication list, allergies, test results) among providers of care and patient-authorized entities
• Perform medication reconciliation at relevant encounters and each transition of care (i.e., moving patients from one setting or provider to another)

Population and public health reporting

• Submit electronic data to immunization registries where required and accepted
• Provide electronic syndrome surveillance data to public health agencies according to applicable law and practice

Ensuring privacy and security

• Comply with federal and state HIPAA rules
• Comply with fair data sharing practices set forth in the Nationwide Privacy and Security Framework

Proving compliance
To prove compliance with these criteria in year one of EHR implementation in order to receive the federal incentives, physicians will have to report on roughly 30 measures, such as percentage of diabetics with A1C under control, percentage of smokers offered smoking-cessation counseling, percentage of all medications entered into EHR as generic when generic options exist and percentage of claims submitted electronically to all payers.

To view all of the measures, see the "Meaningful Use Matrix." This document also lists the criteria for 2013 and 2015 (or year three and year five of EHR implementation).

A major concern for physicians is whether the 2011 measures as a whole will be achievable. Additionally, there is concern that physicians won’t understand the details of what’s required to demonstrate meaningful use and will implement an EHR but fail to qualify for the stimulus payments.

Posted at 09:42AM Jul 21, 2009 by Brandi White  |  Comments[3]