Introduction to Meaningful Use
Background
The Centers for Medicare and Medicaid Services (CMS) released a final rule regarding Meaningful Use on Tuesday, July 13, 2010. The Office of the National Coordinator for Health Information Technology (ONC) requires electronic health records (EHRs) to be both tested and certified for meaningful use. The regulations will allow eligible health care professionals and hospitals to qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives designed to improve health care quality, safety, and efficiency.
There are three stages outlined in meaningful use: Stage 1 begins in 2011, Stage 2 in 2013, and Stage 3 in 2015. CMS anticipates full meaningful use adoption by 2015. Each stage will entail the addition of new requirements and reports.
Requirements
Stage 1 defines what is meant by "meaningful use" with regards to electronic health records. The rule's 25 objectives, meant to allow some flexibility, are divided into two sections: core requirements and discretionary or "menu" requirements. There are 15 core requirements that eligible providers (EPs) must meet, and 14 that hospitals (EHs) must meet. There are ten menu requirements, of which EHs and EPs are required to choose five of the ten to complete. Each objective is paired with a measure to determine completion of the goal.
Core set (Must meet all)
- Record patient demographics
- Record vital signs/chart changes
- Maintain current and active diagnoses
- Maintain active medication list
- Maintain active allergy list
- Record adult smoking status
- Provide patient clinical summaries
- Provide electronic health information copy on demand
- Generate and transmit prescriptions electronically
- Use computerized physician order entry for drug orders
- Implement drug-drug/drug-allergy interaction checks
- Be capable of electronic clinical information exchange
- Implement one clinical decision support rule
- Protect patient data privacy and security
- Report clinical quality measures to CMS or states
Menu set (Choose 5)
- Implement drug formulary checks
- Generate patient lists by condition
- Identify patient-specific education resources
- Perform medication reconciliation between care settings
- Provide summary of care for transferred patients
- Send care reminders to patients
- Provide timely patient electronic access to health information
- Public Health Reporting
The final rule requires eligible professionals and hospitals to choose at least one public health objective from the set of menu objectives, which include submitting one of the following:
Next Stages
Stage 2 will begin in 2013. Criteria will be based upon the findings of Stage 1 and are expected to leverage the broader use of the EHR technology implemented during 2011 and 2012. Stage 2 will bring greater emphasis on disease management, clinical decision support, medication management, patient access to personal health information, care transition of care, and bi-directional communication between physicians and public health agencies.
Additional Resources
- American Recovery and Reinvestment Act (ARRA) Opportunities
- Regional Extension Center Information
- Additional Information on Meaningful Use Certification
- Meaningful Guidance: Definitions
