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Meaningful Use

Perhaps you have already heard that a portion of the TARP funding called ARRA, will increase in your Medicare or Medicaid reimbursements over the next 5 years if you prove “meaningful use” of a “certified”  EMR solution. You may have already heard that with Medicare, you can get up to $44,000, and with Medicaid, up to $64,000. If you have been wondering why nobody has explained to you exactly what “meaningful use” and “certified EMR” means, it Is because your federal government, in typical fashion, has decreed that you must be meaningfully using an EMR BEFORE figuring out themselves what meaningful use means.

In fact, the Electronic Health Record Incentive Program, along with the set of standards, implementation specifications and certification criteria for EHR technology was just released for publication on July 13, 2010, and did not become effective until late September of 2010. The certification process is slow, and there are many vendors in line, so that means that any salesperson that has told you that they have an “ARRA certified” solution prior to September has been dishonest with you.

That being said, now that the standards have been released, it is clear that they are geared towards early adoption. The qualification works on a sliding scale, as each year you must do more to continue to qualify for the increased reimbursements. Those who start early will have to do less than those who wait.

SO WHAT DO WE KNOW NOW?

To meet the minimum requirements for meaningful use in 2011, you must meet a core set of 15 requirements, plus 5 more requirements from a “menu set”, and you must report at least 6 of 44 possible quality control measurements. Below are the 15 “core” requirements. These are not optional, and you must meet each one:

 

Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines

      • Implement drug‐drug and drug‐allergy interaction checks
      • Generate and transmit permissible prescriptions electronically (eRx)
      • Record demographics: preferred language • gender • race • ethnicity • date of birth
      • Maintain an up‐to‐date problem list of current and active diagnoses
      • Maintain active medication list
      • Maintain active medication allergy list
      • Record and chart changes in vital signs: Height • Weight • Blood pressure • Calculate  and display BMI • Plot and display growth charts for children 2‐20 years, including BMI
      • Record smoking status for patients 13 years old or older
      • Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance that rule
      • Report ambulatory quality measures to CMS or the States
      • Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request
      • Provide clinical summaries for patients for each office visit
      • Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically
      • Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilitie

In addition to meeting all of the “core” requirements above, you must also meet at least 5 of the requirements below:

 

      1. Implement drug‐formulary checks
      2. Incorporate clinical lab‐test results into certified EHR technology as structured data
      3. Generate lists of patients by specific conditions to use for quality improvement, reductionof disparities, research or outreach
      4. Send reminders to patients per patient preference for preventive/ follow up care
      5. Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within four business days of the information being available to the eligible provider
      6. Use certified EHR technology to identify patient‐specific education resources and provide those to the patient appropriate
      7. The eligible provider who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation
      8. The eligible provider who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary of care record for each transition of care or referral
      9. Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice*
      10. Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice*

Requirements which are not applicable for your specialty would not apply. For 2011, you will need to use an EMR solution for at least 90 days, and attest that you are using it to qualify for the stimulus money. In 2012, you will have to use it for the entire year, and proving you are using it becomes more difficult.

If you have any questions or concerns, we would be more than happy to help clarify things for you. Give us a call at 877-527-2407 to see what we can do for you.