Meaningful Use Guidelines

Health Care Reform
The Health Information Technology for Economic and Clinical Health (HITECH) Act continues to usher in sweeping health care reforms since it began in January 2011 with the mandatory implementation of health IT infrastructure across practices and hospitals.

The HITECH Act is a component of the American Recovery and Reinvestment Act (ARRA) of 2009; it stipulates eligible health care providers to demonstrate the Meaningful Use of a certified Electronic Health Record (EHR) product, with a financial incentive from the stimulus packages of $19.2 billion.


Meaningful Use in EHR Guidelines

ARRA specifies three main components of Meaningful Use:

1. The use of a certified EHR in a meaningful manner, such as e-prescribing.
2. The use of certified EHR technology for the electronic exchange of health information to improve the quality of health care.
3. The use of certified EHR technology to submit clinical quality and other measures.

Simply put, Meaningful Use means providers need to show they are using certified EHR technology that meets certain mandatory criteria.

What Are the Criteria for Meaningful Use of EHR?
The criteria for Meaningful Use will have to be met in three stages over the course of the next five years:

Stage 1 (2011–2012)
Meaningful Use includes both a core set and a menu set of objectives that are specific to eligible professionals or eligible hospitals and CAHs.

• For eligible professionals, there are a total of 25 Meaningful Use objectives. To qualify for an incentive payment, 20 of these 25 objectives must be met.

1. There are 15 required core objectives.
2. The remaining 5 objectives may be chosen from the list of 10 menu set objectives, and users can defer the other 5 to Stage 2.

• For eligible hospitals and CAHs, there are a total of 24 Meaningful Use objectives. To qualify for an incentive payment, 19 of these 24 objectives must be met.

1. There are 14 required core objectives.
2. The remaining 5 objectives may be chosen from the list of 10 menu set objectives, and users can defer the other 5 to Stage 2.

Stage 2 (2013, anticipated)
The second stage would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. These changes will be reflected by a larger number of core objective requirements for Stage 2. CMS may also consider applying the criteria more broadly to the outpatient hospital setting (and not just the emergency department). Information exchange is a critical part of care coordination and we expect that the infrastructure will support greater requirements for using health information exchanges for Stage 2.

Stage 3 (2015, anticipated)
The final stage would focus on achieving improvements in quality, safety, and efficiency, and on decision support for national high-priority conditions, patient access to self-management tools, access to comprehensive patient data, and improvements to population health outcomes.

How Do I Meet Meaningful Use of EHR Requirements?
To qualify for incentive payments, Meaningful Use requirements must be met in the following ways:

Medicare EHR Incentive Program
Eligible professionals must successfully demonstrate Meaningful Use of certified electronic health record technology every year they participate in the program.

Medicaid EHR Incentive Program
Eligible professionals may qualify for incentive payments if they adopt, implement, upgrade, or demonstrate Meaningful Use in their first year of participation. They must successfully demonstrate Meaningful Use in subsequent participation years.

Adoption
Acquire and install certified EHR technology. (For instance, providers can show evidence of installation.)

Implementation
Begin using certified EHR technology. (For example, provide staff training or data entry of patient demographic information into EHR.)

Upgrading
Expand existing technology to meet certification requirements. (For example, upgrade to certified EHR technology or add new functionality to meet the definition of certified EHR technology.)

Notable differences between the Medicare and Medicaid EHR incentive programs include: