Getting Meaningful with EHR
The Health InformationTechnology for Economic and Clinical Health Act or the “HITECH Act” provides incentive payments for adoption and meaningful use of HIT and qualified EHRs. CMS published a proposed rule defining "meaningful use" on December 30. It's 566 double-spaced pages long, and can be found here: http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf.
An eligible physician or other professional (“EP”) or hospital will be deemed to be a meaningful EHR user of technology certified by HHS if the user:
(1) demonstrates use of certified EHR technology in a meaningful manner;
(2) demonstrates to the satisfaction of the Secretary of HHS that certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care such as promoting care coordination, in accordance with all laws and standards applicable to the exchange of information; and
(3) using its certified EHR technology, submits to the Secretary, in a form and manner specified by the Secretary, information on clinical quality measures and other measures specified by the Secretary.
The measures include:
- Implement drug-drug, drug-allergy, drug-formulary checks.
- Input at least at least one diagnosis based on ICD-9-CM or SNOMED CTor an indication of none for 80% of all unique patients seen by the EP or admitted to an eligible hospital.
- Maintain active medication lists for 80% of patients seen or admitted.
- Record demographic info including preferred language; insurance type; gender; race; ethnicity and date of birth for 80% of patients seen or admitted
- Record blood pressure and BMI and plot the growth chart for children age 2 to 20 years old for 805 of patients seen or admitted;
- Record smoking status of 80% of patients age 13 or over;
- Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research and outreach.
- Implement five clinical decision support rules relevant to the relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules.
- Check insurance eligibility electronically for 80% of patients
- Submit 80% of claims electronically
- Provide summary of care record for at least 80% of transitions of care and referrals
- Use computerized provider order entry (CPOE) for 80% of orders.
- Transmit at least 75 percent of all permissible prescriptions electronically.
- Report clinical quality measures as required by HHS.
- Send electronic reminders to at least 50 percent of all unique patients seen by the EP that are 50 years of age and over.
- Provide requested electronic copies of patients’ health information within 48 hours of patient requests in 80% of cases.
- Provide patients with timely electronic access to their health information (including diagnostic test results, problem list, medication lists, and allergies) within 96 hours of the information being available to the EP for at least 10 percent of all unique patients seen by the EP.
- Provide clinical summaries to patients for each office visit for at least 80 percent of all office visits.
Nice post. Seem tree on most accounts but I also think that
today medical practitioners are looking to avail of this federal incentive by trying to comply with the definition of meaningful use but at the same time EHR providers are looking at their own set of profits.
This misunderstanding is mostly I believe as a result of wrong interpretation of the federal guidelines. The EHR providers need to look at these guidelines from the prospective of the practitioners who deal with different specialties.
Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by in most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
I think ROI is very important factor that should be duly considered when look achieve a 'meaning use' out of a EHR solution. Though one may get vendors providing 'meaning use' at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment. Found a pretty useful ROI tool that is pretty customizable and easy to use. It also accounts for the different specialty EHR's too.
Some of the other useful resources on this topic:
REC's putting EHR's to meaningful use
Certification criteria for EHR
Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the
’safe vendor challenge’ as discussed by many critics.