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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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Filed under: Information Technology | Tagged: American Recovery and Reinvestment Act, Carol Miller RN, CMS, EHRs, meaningful use, Office of the National Coordinator, ONC, PHRs | 8 Comments »
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