Tarrytown, NY, March 17, 2010 - To fulfill the stimulus criteria in healthcare IT, it is very important to be in the right direction, which will lead us to the precise definition of “Meaningful Use of EHR/EMR”. The Government has given us enough time to evaluate this definition by getting several inputs from practitioners and different forums. The department of Health and Human Services (HHS) will be defining the clear definition of “meaningful use” this year.

Here is the ONC’s (Office of the National Coordinator for Health Information Technology) latest definition of certified EHR technology:

“A Complete EHR or a combination of EHR Modules, each of which (1) meets the requirements included in the definition of a Qualified EHR; and (2) has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the [ONC].”

The Centers for Medicare & Medicaid Services (CMS) has announced a proposed rule to implement provisions of the American Recovery and Reinvestment Act of 2009 (Recovery Act) that provide incentive payments for the meaningful use of certified EHR technology. To qualify for incentives, physicians and hospitals must be using “certified EHR technology” in a “meaningful manner.”

This fact sheet summarizes CMS’ proposed definition of meaningful use and how a particular EMR can fit into that definition.

Through the Medicare and Medicaid EHR incentive programs, CMS hopes to expand the meaningful use of certified EHR technology. Certified EHR technology used in a meaningful way is one piece of a broader Health Information Technology infrastructure needed to reform the health care system and improve health care quality, efficiency, and patient safety.

CMS’ proposed rule would phase in more robust criteria for demonstrating meaningful use in three stages.

Stage 1 Criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.

The following list of 25 Stage 1 Meaningful Use criteria for eligible providers was taken from the proposed rule: "Medicare and Medicaid Programs; Electronic Health Record Incentive Program."

Stage 2 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.

Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

Table 1--Stage of Meaningful Use Criteria by Payment Year

* Avoids payment adjustments only for EPs in the Medicare EHR Incentive Program.
** Stage 3 criteria of meaningful use or a subsequent update to the criteria if one is established through rulemaking.

For physician practices incentive could amount to a total of $44,000. For hospitals, depending on the number of discharges, the amount will be somewhere between $2 million to $3.8 million. These incentive amounts are to be paid over three stages, or years, starting in 2011.

On the other hand if a provider does not implement an EMR or CPOE, or purchases and implements a system but cannot show meaningful use, then a penalty will be incurred on Medicare payments in years 2015 thru 2017. This penalty will be in the form of a reduction to the legislated increase in Medicare payments for that year. Note this is not a reduction in overall Medicare payments, but a reduction on the yearly Medicare inflationary adjustment factor. The first year the penalty is a 33% reduction of the adjustment, the second 66%, the third 100%, or in effect, you will get no adjustment at all. It applies only to Medicare and Medicaid programs and not private and commercial insurances.

To qualify for Stimulus Package eligibility, the following can help to meet all the criteria of “meaningful use” of EMR.

• Use of EHR technology certified as having met the final federal criteria and standards for Stage 1 by a certification body accredited by the Office of the National Coordinator for Health Information Technology. No organizations are currently accredited but the Certification Commission for Health Information Technology (CCHIT®) has announced its intent to apply for certification.
• Electronic Medical Records (EMR) and Practice Management (PMS) product and services with unparalleled reliability, ease-of-use, efficiency and customizability.

• HIPAA compliant, web-enabled and supports devices ranging from tablet PCs, handheld to desktop computers. Keeping these regulations in mind, service provider should be backed by technology and coding amenable to all HIPAA policies and be open to current and future HIPAA policies.
• SureScripts Certified, which provides features like eligibility check, drug formulary data with preferred and alternative drug lists and patient drug history data. It is a secure electronic Rx method which reduces human errors and lowers the risk to the patient.

• Solution captures HPI, ROS and physical exams for patients visit.
• The system follows HL7 standards for information sharing and integration across practices and hospitals.
• Getting certified by SSL certificates providers like Thawte, Comodo, Godaddy, Digicert, Entrust, GlobalSign and Network Solutions etc. to ensure complete data security.

• Adopted Vocabulary standards like LOINC, CCD and CCR.

• EMR should be able to increase efficiency and cost savings, improve the quality of patient care, save time, provide a greater ease in invoicing and payment, significant improvements, streamline and customize health encounters.

It is advisable to go for EMR/EHR which satisfies all above criteria.

The content of 25 Stage 1 Meaningful Use criteria table used in this article is taken from article published in http://www.healthcareitnews.com/blog/updates-meaningful-use-certified-ehr-technology-and-stimulus-bill

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