Physicians and healthcare providers across the country have found themselves scrambling to get their arms around the government’s plan to ensure electronic health records (EHR) are implemented within a few short years. It’s easy enough to understand the concept of adoption incentives, which will be activated in 2011, as well as the penalties for noncompliance to be imposed soon after.
Physicians and healthcare providers across the country have found themselves scrambling to get their arms around the government’s plan to ensure electronic health records (EHR) are implemented within a few short years. It’s easy enough to understand the concept of adoption incentives, which will be activated in 2011, as well as the penalties for noncompliance to be imposed soon after. But other components of the plan are less concrete.
One of the major hurdles healthcare providers have encountered is the criterion that they prove they are “meaningful users” of EHR to be eligible for incentive bonuses. Everyone can agree that “meaningful use” sounds like a good idea – but, until now, no one has known exactly what it entails.
Fortunately, this grey area is close to being finalized. Throughout the summer, the Office of the National Coordinator for Health Information Technology (ONC) has entertained proposals and public comment as it developed a working definition for “meaningful use.” The broad goal they have recommended to the Department of Health and Human Services (HHS) is that meaningful use “enable significant and measurable improvements in population health through a transformed health care delivery system.”
To accomplish this, ONC recommended specific objectives for physicians to meet as they begin using automated systems. Criteria for the 2011 deadline include:
- Allowing patients to access their health records in a timely manner;
- Developing capabilities to exchange health information where possible;
- Implementing at least one clinical decision support rule for a specialty or clinical priority;
- Providing patients with electronic copies of discharge instructions and procedures;
- Submitting insurance claims electronically; and
- Verifying insurance eligibility electronically when possible.
ONC also called for enabling patient access to personal health records by 2013 and will require that all providers participate in a national health data exchange by 2015.
While these standards present no small challenge, the fact that they have been articulated represents enormous progress. Although these recommendations do not yet carry the force of regulation, all messages from the Center for Medicare and Medicaid Services (CMS), the HHS implementation arm for the program, have indicated that these measures can be relied upon for the final rule.
Many healthcare organizations have hesitated to make purchasing decisions about EHR systems until they understood more clearly what CMS would ask of them. Now they have the clearest signals so far.
We must keep in mind that, while clearing the “meaningful use” hurdle is a major accomplishment, other challenges remain – like determining the most appropriate approach to EHR certification. We will discuss factors impacting this issue in future posts.
All the guidelines may not be specified yet, but physicians must balance the details of meaningful use and certification plans with the impending deadlines – i.e., achieving meaningful use by January 2011. In my opinion, finalizing EHR plans should be a major goal for all medical providers in the next few months.
Charlie Jarvis, FACHE, Vice President for Healthcare Industry Services and Government Relations
