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Final Meaningful Use Rules Released by HHS on July 13, 2010.
[By Shahid N. Shah MS]
Link: http://shahid.shah.org
For ambulatory care practices and physicians there are about 25 objectives and measures that must be met to become a “meaningful user”. Keep in mind that meaningful use is not tied to a certified EHR alone; in fact, unless you use the EHR properly and in all the ways the government wants you to, you will not be a “meaningful user”. Don’t be fooled by EHR vendors guaranteeing that they will make you a “meaningful user” – no vendor’s software, no matter how nice, can get your staff to use the software in the way the government wants. You, as the CIO of your practice, are the only one that can guarantee that. In fact, you don’t even need an EHR from a vendor to meet the requirements – you can even roll your own, use open source, or find any other means. But, in general, as long as you can attest and send data to the government that they require you can do it in any way that you want. Be aware that some unscrupulous vendors are scaring practices and making promises that they cannot keep.
Final MU Rules
The final Meaningful Use (MU) Rule was published by HHS on July 13, 2010. It defines 24 objectives for and measures eligible hospitals that could be met to become a meaningful user and qualify for incentive funding. There is a “core set” that must be met by all institutions and a “menu set” of from which organizations must implement at least 5 objectives.
Core Set Objectives
These are the “core set” of 14 objectives that must be met by all institutions and a “menu set” of 10 from which organizations must implement at least 5 objectives (at least 1 public health objective must be chosen from that set).
- Use Computer Provider Order Entry (CPOE).
- Implement drug-drug, drug-allergy, and drug-formulary checks.
- Record demographics.
- Implement one clinical decision support rule.
- Maintain a problem list of current and active Dxs based on ICD-9-CM or SNOMED CT.
- Maintain active medication list.
- Maintain active medication allergy list.
- Record and chart changes in vital signs.
- Record smoking status for patients 13 years or older.
- Report hospital clinical quality measures to CMS or States.
- Provide patients with an electronic copy of their health information, upon request.
- Provide patients an e-copy of discharge instructions at time of discharge, upon request.
- Exchange key clinical e-information among providers and patient-authorized entities.
- Protect electronic health information.
Menu Set Objectives
These are the “menu set” of 10 objectives from which organizations must implement at least 5. At least one public health objective must be chosen from this set as well (numbers 8, 9, or 10).
- Drug-formulary checks.
- Record advanced directives for patients 65 years or older.
- Incorporate clinical lab test results as structured data.
- Generate lists of patients by specific conditions.
- Use certified eHR technology to identify patient-specific education resources and provide to patient, if appropriate.
- Medication reconciliation.
- Summary of care record for each transition of care/referrals.
- Capability to submit electronic data to immunization registries/systems.
- Capability to provide electronic submission of reportable lab results to public health agencies.
- Capability to provide electronic syndromic surveillance data to public health agencies.
Assessment
As can be seen in the link below, the Office of the National Coordinator for Healthcare IT (ONCHIT) is a component of the Department of Health and Human Services (HHS). ONCHIT, usually abbreviated just ONC, is the principal policy group of the Federal Government that defines and manages NHIN.
- ONC is responsible for coordinating with the Department of Commerce’s National Institute of Standards and Technology (NIST) on the specifications for the NHIN standards.
- The HIT Policy and HIT Standards Committees are the working groups that advise ONC on what to put in the standards.
- NIST is responsible for coming up with the test materials (assertions, procedures, methods, tools, data, and so on) that will be used to certify working systems.
Conclusion
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Filed under: Book Reviews, Information Technology, Practice Management | Tagged: CCHIT, CMS, Computer Provider Order Entry, CPOE, Department of Commerce’s National Institute of Standards and Technology, EHRs, EMRs, HHS, ICD-9-CM, meaningful use, Meaningful Use of eMRs, NHIN, NIST, Office of the National Coordinator for Healthcare IT, ONC, ONCHIT, Shahid N. Shah, SNOMED CT |
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More on the Final meaningful use rule announced July 13, 2010
As noted above, Federal officials released the final rule on meaningful use on Tuesday, July 13th, which allows physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.
http://www.healthcareitnews.com/news/flexibility-built-final-rule-meaningful-use
Craig
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Even More on Meaningful Use
http://www.softwareadvice.com/articles/medical/the-stimulus-bill-and-meaningful-use-of-qualified-emrs-1031209/
Chris Thorman
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MU Revisions
The Centers for Medicare and Medicaid Services [CMS] plans to correct a few inconsistencies in the meaningful use final rule it published in July and will post on its Web site more detailed guidance for providers on how to meet quality measures required by the health IT incentive program.
The minor revisions will include more detailed descriptions of each of the meaningful use objectives and measures. The panel met to propose preliminary requirements for the second stage of meaningful use in 2013, such as raising the level of performance required for computerized physician orders, electronic prescribing and other measures that were begun in the first stage.
http://www.govhealthit.com/newsitem.aspx?nid=74711
Craig
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Interoperability Key to Realizing Health IT Goals
Without “seamless interoperability,” health information technology’s potential will go unmet, a report on the healthcare digital infrastructure from the Institute of Medicine found. That was the conclusion of health IT experts during a series of “expert meetings” organized by the Institute of Medicine in the summer and fall of 2010 at the request of the federal Office of the National Coordinator for Health Information Technology.
Those experts – researchers, computer scientists, privacy experts, clinicians, healthcare administrators, HIT professionals, and representatives of patient advocacy groups – agreed that a digital health infrastructure cannot be effective unless it is integrated seamlessly within the healthcare processes “from which it draws and is meant to support care delivery, research, quality improvement, and population health monitoring.” Other critical components for the success of health IT, as identified by meeting participants, include the ease of technology use for health system stakeholders, attention to systems’ effects on work flow, and the delivery of useful decision support at point of care.
Source: Rich Daly, Modern Healthcare [5/23/11]
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EHR Adoption Rate Slows – Physicians Facing Big Hurdles for Meeting Stage 2
The pace of adoption of electronic health-record systems has begun to slow, and the physicians who have adopted systems have a long way to go to meet the government’s Stage 2 criteria for meaningful use of the technology, according to an authoritative survey of practices by the National Center for Health Statistics at HHS. In 2013, the third year of the federal EHR incentive payment program, nearly 8 in 10 office-based physicians had adopted some form of an electronic health-record system, and nearly half of them had a “basic” system with key EHR functions defined.
The latest installment of the annual National Ambulatory Medical Care Survey, conducted between February and June last year, also showed that most physicians were far from meeting the incentive payment program’s Stage 2 “meaningful use” criteria.
For physicians who had met at least two years of Stage 1 requirements, Stage 2 got underway Jan. 1.
Source: Joseph Conn, Modern Healthcare [1/20/14]
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CMS to Reopen Submission Period for Hardship Exception Applications
CMS is announcing its intent to reopen the submission period for hardship exception applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT). The new deadline will be November 30, 2014. Previously, the hardship exception application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.
As part of the American Recovery and Reinvestment Act of 2009 (Recovery Act), Congress mandated payment adjustments under Medicare for eligible hospitals, critical access hospitals, and eligible professionals that are not meaningful users of CEHRT. The Recovery Act allows the Secretary to consider, on a case-by-case basis, hardship exceptions for eligible hospitals, critical access hospitals, and eligible professionals to avoid the payment adjustments.
Source: CMS
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Are Meaningful Use Numbers a Cause for Concern?
Even as CIOs worry about meeting Stage 2 meaningful use requirements, most are charging ahead with programs that truly transform clinical operations.
http://www.hhnmag.com/display/HHN-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Daily/2014/Oct/CIO-worry-meaningful-use-CHIME-blog-video-Weinstock&utm_source=daily&utm_medium=email&utm_campaign=HHN
But, is anyone really surprised.
Jack
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