The meaningful use of certified EHR technology is one piece of the broader health information technology initiative to improve the quality, safety and efficiency of patient care and to create a private and secure 21st century electronic health information system.
The 2009 HITECH Act authorized CMS incentive payments to eligible providers and hospitals when they adopt EHRs and demonstrate use in ways that can improve healthcare.
Meaningful use standards were established to ensure that the focus is on using an EHR to improve and measure health outcomes and processes, and not on the technology itself or on using an EHR as just a digital medical chart.
Two final regulations were published in July 2010—one defines the meaningful use requirements that healthcare providers must meet to qualify for the federal incentive payments; the other states the technical capabilities required for certified EHR technology to ensure that the system you choose meets the meaningful use requirements.
Sections:
- Main Requirements and Outcome Priorities
- Stage 1 Meaningful Use
- Core and Menu Objectives
- Clinical Quality Measures
Main Requirements and Outcome Priorities
According to the 2009 Recovery Act, to be a meaningful user of an EHR, a provider must satisfy three main requirements:
- Use a certified EHR in a meaningful manner (eg, for e-prescribing)
- Demonstrate that the certified EHR provides for the electronic exchange of health information to improve quality of healthcare, such as promoting patients’ coordination of care; and
- Use a certified EHR to submit clinical quality measure reporting
CMS’s definition of meaningful use in its July 28, 2010, final regulation is based on five broad health outcome priorities:
- To improve quality, safety and efficiency of care while reducing disparities
- To engage patients and families in their care
- To improve care coordination
- To promote population and public health; and
- To ensure privacy and security protections for personal health information.
Stage 1 Meaningful Use
The HHS ONC initially published proposed meaningful use requirements in January 2010. Concerns that the requirements were too demanding and inflexible led to the July 2010 revised meaningful use objectives and measures for Stage 1 (2011/2012) of three planned stages/phases. (Meaningful use requirements for the next two phases will be released over the next few years.)
The final rule defines
- Fifteen core objectives and measures that eligible providers and eligible hospitals must meet to qualify for CMS incentive payments, and
- Ten menu set objectives and measures from which providers choose any five to implement.
Be sure to review the meaningful use core and menu set objectives.
Core and Menu Objectives
The core objectives of meaningful use (sometimes referred to as the functional measures) comprise basic EHR functions that support improvements in healthcare, such as entering basic patient data (including vital signs, demographics and active medications and allergies); using clinical decision support tools; and entering clinical orders, particularly medication prescriptions (e-prescribing).
The menu objectives include using an EHR to incorporate clinical lab results, reconciling medications between care settings and providers, and providing reminders to patients for needed care. Most of the core and menu objectives specify the rates at which providers will have to use particular EHR functions to be considered meaningful users.
Clinical Quality Measures
To achieve Stage 1 Meaningful Use of an EHR, providers also have to attest* to data on two clinical quality care measure (CQM) groups comprising a total of six measures:
- A core set of three measures (adult blood pressure levels, tobacco status, and adult weight screening and follow-up) or alternate core measures (weight assessment for children, flu immunization for adults aged 50 and older, and childhood immunization), and
- Three additional measures selected from among a list of 38 others.
The RI REC team is here to help you understand what meaningful use means for your practice. Enroll now and be matched with a REC Relationship Manager who can help you through the EHR adoption process.
*Unlike Medicare providers who need to attest to the meaningful use functional measures and clinical quality measures in their first year of incentive program participation, Medicaid providers do not have to demonstrate meaningful use during their first year of participation. You only have to demonstrate that you have adopted, implemented, or upgraded certified EHR technology. However, you will be required to demonstrate meaningful use in each subsequent year to qualify for an incentive payment.