More on “Meaningful Use” Requirements

Posted on September 12, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

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And  …  Its’ Impact on eHRs

Carol Miller RN MBA millerconsultgroup@gmail.com

The American Recovery and Reinvestment Act of 2009introduced the “Meaningful Use” requirement for EHR systems with three main components:

The Components

1) The use of a certified EHR in a meaningful manner, such as e-prescribing, 2) The use of a certified EHR technology for electronic exchange of health information to improve quality of health care, and 3) The use of a certified EHR technology to submit clinical quality and other measures.

Meaningful Use refers to a set of 15 criteria that medical providers must meet in order to prove that they are using their EHRs as an effective tool in their practice.  There are also 10 additional criteria that are considered a la carte from which only 5 need to be demonstrated by the medical provider.

In total, 20 Meaningful Use criteria must be used within the EHR to qualify for stimulus payments during Stage One of the EHR incentive program.   Each of the criteria were developed and further reviewed by the Office of the National Coordinator [ONC] with public input.

A Five Year TimeLine

Meaningful use will be measured in stages over five years.  Each stage represents a level of adoption.  Many certified EHRS will allow providers to complete all Meaningful Use criteria, whereas others will only certify what is required in the early stages and modify at a later date with any new criteria.

The three stages are:

Stage One:  Essentially, Stage One is using the major functionality of a certified EHR.  This includes documenting set percentages of your visits, diagnoses, prescriptions, immunizations and other relevant health information electronically; using the clinical support tools (warnings and reminders that will be included in a certified EHR); and sharing patient information.  Providers and hospitals must report quality measures and public health information. For providers they must report on 6 clinical quality measures – 3 required core measures and 3 additional measures selected from a set of 38 clinical quality measures.  Eligible hospitals and Critical Care Hospitals (CAHs) must report on all 15 of the clinical quality measures.  Stage One is required in years 2011 and 2012.

Stage Two:  In addition to continuing to use all functionality from Stage One, physicians will be required to use EHRs to send and receive information such as lab orders and results.   Other criteria may be added.  Stage Two is expected to be implemented in 2013.

Stage Three:  This stage will continue fulfilling the criteria from Stages One and Two and will include clinical decisions support for national high priority conditions; emailing patients in a Personal Health Record (PHR); accessing comprehensive patient data; and improving population health.  Stage Three criteria have not been developed to date and the implementation is not expected until 2015.

Assessment

CMS payment penalties for non-compliance to the meaningful use regulations will begin in 2016 with an initial 1% penalty which could escalate to 5% five years later.  Therefore, with these criteria in place, we are likely to see virtually all hospitals attempt to meet the meaningful use criteria to avoid penalty cost.

Conclusion

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8 Responses

  1. Tired MD, on September 13, 2012 at 12:13 AM said:

    Carol,

    I see about 32-35 patients in a long 8 hours of apopmntients day. Spend a total of about 101/2 hours these days at the office, counting a working lunch and a few minutes before clinic and time to wrap up charts at the end of the day. I never leave until all notes are done.

    You can tell I am a believer that our EMR makes my care better and life no worse.

    Tired MD

    Like

  2. Hope Rachel Hetico RN MHA, on February 23, 2013 at 12:52 PM said:

    The Final MU Requirements?

    Click to access Final-Meaningful-Use-Matrix.pdf

    Hope Rachel Hetico RN MHA

    Like

  3. Ann Miller RN MHA, on April 3, 2013 at 10:03 AM said:

    Bill Would Offer Meaningful-Use Exemptions

    A Republican congresswoman from Tennessee has introduced legislation that would exempt solo practitioners and physicians nearing retirement from the upcoming Medicare reimbursement cuts for physicians who do not meet meaningful-use requirements for electronic health-record systems under the American Recovery and Reinvestment Act.

    Rep. Diane Lynn Black, a former nurse and member of the House Budget and Ways and Means committees, re-introduced her Electronic Health Records Improvement Act last month. Physicians who don’t meet meaningful-use targets this year under the Medicare version of the EHR incentive payment program face a 1% cut in their Medicare reimbursements in 2015.

    Source: Joseph Conn, Modern Healthcare [April 1, 2013]

    Like

  4. D. Kellus Pruitt DDS, on July 19, 2013 at 4:41 PM said:

    Propaganda?

    If you witnessed propaganda, would you recognize it?

    I have noticed that Dental Software Advisor is the only internet publication pushing dentists to adopt Meaningful Use requirements – which everyone outside Washington DC knows benefit neither patients nor dentists. Promoting MU in dentistry is so absurd that one has to wonder what is in it for DSA.

    “Should Blood Pressure be Required in Dental Electronic Health Records?” (no byline)

    http://www.dentalsoftwareadvisor.com/should-blood-pressure-be-required-in-dental-electronic-health-records/

    Contrary to the anonymous author’s opinion, dentists have never required EHRs to monitor patients’ blood pressure.

    I don’t think HHS yet understands that MU requirements for dentists are even harder to defend than for physicians – who are abandoning them. That is why I think taxpayer money funded Dental Software Advisor’s press release. I suspect the PR giant Ketchum Inc. and possibly a quiet federal grant were involved.

    D. Kellus Pruitt DDS

    Like

  5. Ann Miller RN MHA, on September 26, 2013 at 3:33 AM said:

    Fewer Certified EHRs for Stage 2 May Pose Problems for Docs

    There is growing concern that far fewer software developers have certified electronic health-record systems for use by healthcare providers under federal Stage 2 meaningful-use requirements than under Stage 1.

    A Modern Healthcare review of the Certified Health IT Product List compiled by HHS’ Office of the National Coordinator for Health Information Technology shows that just 79 companies, providers, and other organizations have developed software and had it tested and certified to ONC-determined software functionality standards for Stage 2 meaningful-use requirements. In comparison, there were 988 developers of health information technology systems tested and certified for Stage 1.

    This could cause problems for hospitals and office-based physician practices, which must advance quickly from Stage 1 to Stage 2 to avoid penalties, but still don’t have tested and certified systems for meeting the Stage 2 requirements.

    Experts say vendors are facing problems as they try to develop EHR systems capable of performing calculations for measures providers must report to the CMS under the Stage 2 meaningful-use requirements.

    Source: Joseph Conn, Modern Healthcare [9/25/13]

    Like

  6. Garfunkel Wild PC, on December 13, 2013 at 11:06 PM said:

    Meaningful Use Audits On the Rise

    Medicare and Medicaid have increased their audits of providers who attested to “meaningful use” in order to receive payments under the Medicare and Medicaid Electronic Health Record Incentive Program (“EHR Incentive Program”).

    All physicians and hospitals that have attested to meaningful use under the EHR Incentive Program may be subject to a meaningful use audit. Unfortunately, many providers are learning that these meaningful use audits are more stringent than expected.

    http://garfunkelwild.com/ClientAlerts/AlertPages/2013/MeaningfulUse.htm

    To read the entire Legal Alert, please click the above link.

    Garfunkel Wild PC

    Like

  7. Brenda, on June 15, 2014 at 12:48 PM said:

    Why achieving EHR meaningful use is not enough to improve quality

    A new study casts doubt on whether the billions of dollars spent so far in meeting meaningful use requirements is actually improving patient outcomes.

    http://medicaleconomics.modernmedicine.com/medical-economics/news/why-achieving-ehr-meaningful-use-not-enough-improve-quality

    Brenda

    Like

  8. Hope R. Hetico RN MHA, on August 30, 2014 at 1:47 AM said:

    CMS Finalizes EHR Meaningful-Use Rule and Adds Some Flexibility

    CMS just finalized a rule allowing hospitals and eligible professionals more flexibility in how they meet meaningful-use requirements for the electronic health-record incentive program. The agency had first proposed the idea in a May draft rule. This final rule left the May proposal unchanged.

    The rule would grant providers a longer timeline and more flexibility in meeting the incentive goals laid out by the stimulus program first created in the 2009 HITECH Act. The incentive program provides doctors and hospitals stimulus funding to implement electronic health records. The rule pushes back the beginning of the third stage of meaningful use for the first cohort of adopters until Jan. 1, 2017, as opposed to the old standard of Jan. 1, 2016.

    Source: Darius Tahir, Modern Healthcare [8/29/14]

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