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Electronic Health Records: meaningful use

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Electronic Health Records: Meaningful Use

 

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, encouraged national development of electronic records technology and use.   The act authorized incentive payments through Medicare and Medicaid to clinicians and hospitals that use certified software technogies to manage electronic health records (EHRs) in a meaningful way that significantly improves clinical care. 

The HITECH act contained provisions that require "Meaningful Use" of EHR for eligible health care providers to be in compliance with and eligible for federal financial incentives.

Adoption Standards

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What is meaningful use?

Electronic health records can provide many benefits for providers and their patients, but the benefits depend on how they're used. Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria. For details about the incentive programs, visit the CMS website.

The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States.

The benefits of the meaningful use of EHRs include:

  • Complete and accurate information. With electronic health records, providers have the information they need to provide the best possible care. Providers will know more about their patients and their health history before they walk into the examination room.
  • Better access to information. Electronic health records facilitate greater access to the information providers need to diagnose health problems earlier and improve the health outcomes of their patients. Electronic health records also allow information to be shared more easily among doctors' offices, hospitals, and across health systems, leading to better coordination of care.
  • Patient empowerment. Electronic health records will help empower patients to take a more active role in their health and in the health of their families. Patients can receive electronic copies of their medical records and share their health information securely over the Internet with their families.

Background: Legislation and Regulations
The Health Information Technology for Economic and Clinical Health (HITECH) Act provides the Department of Health & Human Services (HHS) with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange.

Under HITECH, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.

Four regulations have been released, two of which define the “meaningful use” objectives that providers must meet to qualify for the bonus payments, and two of which identify the technical capabilities required for certified EHR technology.

  • Incentive Program for Electronic Health Records: Issued by CMS, these final rules define the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payments for Stages 1 and 2 of meaningful use.
  • Standards and Certification Criteria for Electronic Health Records: Issued by the Office of the National Coordinator for Health Information Technology (ONC), these rules identify the standards and certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they adopt are capable of performing the required functions.

The U.S. Department of Health and Human Services recently announced the release of the final rules for Stage 2 of meaningful use and updated certification criteria and standards. Learn more about the final rules and read about meaningful use clinical quality measures.

Stages of Meaningful Use

In order to achieve meaningful use, eligible providers and hospitals must adopt certified EHR technology and use it to achieve specific objectives.

These meaningful use objectives and measures will evolve in three stages over the next five years:

  1. Stage 1

2011-2012

Data capture and sharing

  1. Stage 2

2014

Advance clinical processes

  1. Stage 3

2016

Improved outcomes

Stage 1:
Meaningful use criteria focus on:

Stage 2:
Meaningful use criteria focus on:

Stage 3:
Meaningful use criteria focus on:

Electronically capturing health information in a standardized format

More rigorous health information exchange (HIE)

Improving quality, safety, and efficiency, leading to improved health outcomes

Using that information to track key clinical conditions

Increased requirements for e-prescribing and incorporating lab results

Decision support for national high-priority conditions

Communicating that information for care coordination processes

Electronic transmission of patient care summaries across multiple settings

Patient access to self-management tools

Initiating the reporting of clinical quality measures and public health information

More patient-controlled data

Access to comprehensive patient data through patient-centered HIE

Using information to engage patients and their families in their care

 

Improving population health

Achieving meaningful use during Stage 1 requires meeting both core and menu objectives. All of the core objectives are required. EPs and hospitals may choose which objectives to meet from the menu set. Learn more about Stage 1 and how to attain meaningful use.

The U.S. Department of Health and Human Services recently announced the release of the notices of proposed rule-making (NPRMs) for Stage 2 of meaningful use and updated certification criteria. Learn more about the proposed rule.

Meaningful Use Attestation

The Office of the National Coordinator for Health IT along with the Center for Medicare and Medicaid Services have compiled a list of Electronic Health Record products used for the attestation of Meaningful Use under the CMS Medicare and Medicaid EHR Incentive Program. The file containing this data is in a csv format and is updated monthly. In addition, a data dictionary is provided that describes the variables available in the dataset. Finally, a factsheet is offered to explain how the data is generated and how to best use it.

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http://www.healthit.gov/policy-researchers-implementers/meaningful-use