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Electronic Health Records
Final "Meaningful Use" regulation for electronic health records released
The popularity of using electronic health records (EHRs) in the United States is becoming rapidly widespread these days.
This is inevitable because EHRs improve healthcare providers’ decisions and patients’ outcomes. And hundreds of thousands of physicians have already proven and experienced the benefits that EHRs provide in their clinical practice and this is also because once patients experience the benefits of this technology; they demand nothing less from their providers.
However, this inevitable circumstance does not mean easy transition because there have been years of professional agreement and bipartisan consensus with regards to the potential value of EHRs.
Truth is there has not yet been a significant action that extends the availability of EHRs from a few large institutions to the smaller clinics and practices where most Americans receive their health care.
In particular, concerns about the pace and scope of implementation of meaningful use led the Department to adopt a two-track approach regarding the objectives that allow practices and hospitals to qualify for incentive payments in the first 2 years of the program.
The most important part of this regulation is what it says hospitals and clinicians must do with EHRs to be considered meaningful users in 2011 and 2012.
In the original proposal, DHHS identified a broad set of objectives, all of which would need to be met including 23 objectives for hospitals and 25 for clinicians and they also received many comments that this approach was too demanding and inflexible, an all-or-nothing test that too few providers would be likely to pass.
In the final regulation, DHHS have divided these elements into two groups: a set of core objectives that constitute an essential starting point for meaningful use of EHRs and a separate menu of additional important activities from which providers will choose several to implement in the first 2 years.
To view a complete summary overview of Meaningful Use objectives visit NEJM.org.
The Core objectives comprise basic functions that enable EHRs to support improved health care and as a start, these include essential tasks to creating any medical record, including the entry of basic data: patients’ vital signs and demographics, active medications and allergies, up-to-date problem lists of current and active diagnoses, and smoking status.
Other core objectives include using several software applications that begin to realize the true potential of EHRs to improve the safety, quality, and efficiency of care. These features help clinicians make better clinical decisions while avoiding preventable errors.
To qualify for incentive payments, clinicians must start employing such clinical decision support tools and they must also start using the capability that undergirds much of the value of EHRs such as using records to enter clinical orders and, in particular, medication prescriptions.
Only when providers enter orders electronically can the computer help improve decisions by applying clinical logic to those choices in light of all the recorded patient data and to begin extending the benefits of EHRs to patients themselves, the meaningful use requirements will include providing patients with electronic versions of their health information.
In addition to the core elements, the rule creates a second group: a menu of 10 additional tasks, from which providers can choose any 5 to implement in 2011–2012 giving them latitude to pick their own path toward full EHR implementation and meaningful use.
For most of the core and menu items, the regulation also specifies the rates at which providers will have to use particular functions to be considered meaningful users. Reflecting the views and experiences shared during the comment period, these rates will enable significant progress toward improving care − but are also achievable by average practices and providers in the early years.
The HITECH legislation further requires that meaningful use include electronic reporting of data on the quality of care. In the final regulation, they have simplified the January proposals for quality reporting while still building toward a robust reporting capability that will inform providers about their own performance and will eventually inform the public as well. Clinicians will have to report data on three core quality measures in 2011 and 2012: blood-pressure level, tobacco status, and adult weight screening and follow-up (or alternates if these do not apply). Clinicians must also choose three other measures from lists of metrics that are ready for incorporation into electronic records.
The meaningful use rule is part of a coordinated set of regulations to help create a private and secure 21st-century electronic health information system.
On June 18, 2010, the DHHS issued a rule that laid out a process for the certification of electronic health records, so that providers can be assured they are capable of meaningful use and they also issued still another regulation that lays out the standards and certification criteria that EHRs must meet in order to be certified.
And finally realizing that the privacy and security of EHRs are vital, the DHHS has been working hard to safeguard privacy and security by implementing new protections contained in the HITECH legislation.
The meaningful use rule strikes a balance between acknowledging the urgency of adopting EHRs to improve our health care system and recognizing the challenges that adoption will pose to health care providers. The regulation must both be ambitious and achievable because like an escalator, HITECH attempts to move the health system upward toward improved quality and effectiveness in health care. However, the speed of ascent must be calibrated to reflect both the capacities of providers who face a multitude of real-world challenges and the maturity of the technology itself.
And as part of this process, the DHHS is establishing a nationwide network of Regional Extension Centers to assist providers in adopting qualified EHRs and making meaningful use of them. The DHHS is committed to the support, collaboration, and ongoing learning that will mark our progress toward electronically connected, information-driven medical care in the hope that providers and consumers will join in the effort to assure that we make the best possible use of our most precious health care resource: information about the patients we serve
Click here to know more about the Medicare & Medicaid EHR Incentive Program Final Rule.
For more detailed information on how to take advantage of Federal Stimulus Incentives, State Incentives and how you can become a meaningful user, contact us at info@meditab.com or call us at: (866) 99 Go-EMR
