Meaningful Use, Take II

StampofapprovalResponding to public feedback on a working group’s proposal made last month, the federal HIT Policy Committee has released updated recommendations for defining the term, “meaningful use” of electronic medical records.
The new recommendations include modifications to the criteria for computerized order entry and a more aggressive time frame for the implementation of personal health records.
The recommendations now go to the Office of the National Coordinator for Health Information Technology (ONCHIT) and other branches of HHS, who will use them as guidance in developing rules to implement the incentive programs.
The final product should be released before year end.
HITECH legislation states that providers must demonstrate meaningful use of an EMR in order to qualify for bonus payouts under Medicare and Medicaid beginning in 2011.
In an important change designed to ease pressure on providers, the Policy Committee has recommended that its 2011 criteria should apply not just to 2011, but to whatever year a particular provider decides to implement his or her EHR.
Thus if a practitioner decides to go live with an EHR in, say, 2013, he or she will be required to meet 2011 criteria for meaningful use in order to qualify for bonus funding.
The Policy Committee has retained the guideline matrix originally proposed by its working group, but made several modifications to it, most notably with respect to the adoption of CPOE.
Here, the working group’s proposed requirement that providers must use CPOE for “all” orders in 2011 has been diluted to state that 10% of orders “of any type” must be entered by an authorized provider in order to qualify. This will allow pilot CPOE projects and phased implementations to meet the requirement
The revised criteria also require providers to:

  • Implement one clinical decision support rule relevant to a specialty or a high clinical priority;
  • Submit claims to payers electronically;
  • Check insurance eligibility electronically when possible;
  • Provide patients with timely electronic access to their health information;
  • Provide patients, upon request, with an electronic copy of their discharge instructions and procedures at the time of discharge; and
  • Be able to exchange health information where possible in 2011, and participate in a national health information exchange by 2015.

They also state that by 2013, all patients should be given access to personal health records that are populated in real-time. That’s 2 years earlier than the working group had proposed.
The complete recommendations soon will be available at http://healthit.hhs.gov. Click on Public-Private Initiatives, then Health IT Policy Committee.
Glenn Laffel, MD, PhD, Senior VP, Clinical Affairs

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