Health Care Providers Should Prepare to Make “Meaningful Use” of EHR
It’s not just a new techo-fad – the federal government is serious about Electronic Health Records.
How serious? Enough so that one of the many health care-related provisions tucked into this year’s American Recovery and Reinvestment Act (a.k.a. the Stimulus Bill) mandates that health care providers make “meaningful use” of Electronic Health Records (EHRs) by 2011. Providers who fail to do so will be penalized in the form of reduced Medicare and Medicaid reimbursements. However, the proverbial “carrot” is that providers who do make meaningful use of EHRs can receive thousands of dollars in Medicare/Medicaid incentive payments, as well as grant monies to help implement EHR systems.
According to an open letter released earlier this month by David Blumenthal, the National Coordinator for Health Information Technology, eligible physicians (including those in solo or small practices) who make “meaningful use” of certified EHRs can receive up to $44,000 over five years in Medicare incentive payments, or $63,750 over six years under Medicaid. Hospitals that become meaningful EHR users could receive up to four years of financial incentives payments under Medicare beginning in 2011, and up to six years of incentive payments under Medicaid beginning in October 2012.
What is “Meaningful Use”?
The question most providers are undoubtedly asking at this point is – what exactly does “meaningful use” mean? A formal definition of what constitutes “meaningful use” will be issued by the Centers for Medicare and Medicaid Services (CMS), which is scheduled to publish a definition by December 31.
After the jump - a glimpse at what may constitute "meaningful use"
In the meantime, the federal Health IT Policy Committee has issued recommendations to the National Coordinator which suggest that the following criteria be used in evaluating whether a provider is making “meaningful use” of ERH:
Electronic Prescribing
Congress believes that e-prescribing will reduce medical errors, save time for doctors and patients, and cut down on transaction costs. The goal is that e-prescribing will help streamline case in a few ways; first, it will allow providers to access drug formularies online, so they can see what a patient’s health plan will pay for in advance and determine if a less-expensive generic drug can be prescribed as opposed to name brand. Second, it will give providers easy access to alerts from the Food and Drug Administration so they can receive updates on drugs and if there have been any recall issues.
Finally, it will help cut down administrative costs associated with filling drug refills and help reduce errors. A study performed by the Medical Group Management Associate shows that administrative costs related to managing prescription refill requests by phone can cost practices more than $10,000 per year per physician.
Certification
Under the Stimulus Bill, a provider must demonstrate that it is using “qualified” or “certified” EHR technology. For now, providers can look to the independent Certification Commission for Health Information Technology (CCHIT) for a peek of what may be considered “qualified” technology. CCHIT recently launched a modular certification program (dubbed “Preliminary ARRA 2011”) which will endow approved EHR vendors and software with “certified” status, and also indicate which meaningful use objectives are supported by the technology. Note that until the final meaningful use guidelines are issued by CMS, EHR technology that is certified by CCHIT may not necessarily qualify for Medicare/Medicaid incentive funding.
Interoperability
This basically means the ability to share health information with other providers, hospitals and governmental agencies, and includes specific goals such as the ability to exchange health information like labs, care summary, and medication lists with external clinical entities.
Adoption of Clinical Quality Measures
Providers must report certain “quality measures” to CMS to demonstrate that they are working towards a goal of improving the quality, safety and efficiency of patient care. Examples of such reportable “quality measures” include:
- Percentage of hypertensive patients with blood pressure under control
- Percent of patients at high risk for heart attacks, etc.
- Percent of patients who smoke who are offered smoking cessation counseling
- Percentage of patients with LDL cholesterol (low-density lipoprotein – a.k.a “bad cholesterol”) under control
What Can Providers Do For Now?
Given that a final “meaningful use” definition will not be issued until 2010 (a public comment period will follow publication of the proposed rules by CMS in December), providers may be wondering what can be done to prepare for the EHR transition. Blumenthal recommends that in the interim, providers familiarize themselves with the current discussions of “meaningful use” criteria (such as the proposed elements listed above.) For more information, providers can visit:
http://healthit.hhs.gov/meaningfuluse
Or http://healthit.hhs.gov/HITECHgrants for information on future grant monies for EHR systems that will be available.
Most importantly, Blumenthal warns providers from resisting the use and implementation of EHR systems.
“To some providers, particularly small or already stretched physician practices or small, rural hospitals, the path toward meaningful use may still seem arduous,” said Blumenthal in his October 1, 2009 open letter. “To others, who would just prefer to stick with the ‘status quo,’ it may seem like an unwanted intrusion. We believe that the time has come for coordinated action. The price of inaction – in adverse events, lost patient lives, delayed or improper treatments, unnecessary procedures, excessive costs, and so on – is just too high, and will only get worse.”
