Meaningful Use

The Definition of Meaningful Use Requirements
The requirements of meaningful use to qualify for incentive payments was released on July 13, 2010. The final rule definitively outlines all the specifics of Stage 1 meaningful use and clinical quality measure reporting to receive the incentive payments in 2011 and 2012.

The Recovery Act specifies three main components of Meaningful Use:

The use of a certified EHR in a meaningful manner (e.g.: e-Prescribing);
The use of certified EHR technology for electronic exchange of health information to improve quality of health care; and
The use of certified EHR technology to submit clinical quality and other measures.
The definition of meaningful use harmonizes criteria across CMS programs as much as possible and coordinate with existing CMS quality initiatives. It also closely links to the certification standards criteria in development by the Office of the National Coordinator (ONC) and provides a platform for a staged implementation over time.

Specifics of Stage 1 Meaningful Use (2011 and 2012)
Meaningful use includes both a core set and a menu set of objectives that are specific for eligible professionals and hospitals. For Eligible Professionals, there are a total of 25 meaningful use objectives. 20 of the objectives must be completed to qualify for an incentive payment. 15 are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. For Hospitals, there are a total of 24 meaningful use objectives. 14 are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives.

The definition of meaningful use includes reporting of clinical quality measures. See the link titled "Meaningful Use Clinical Quality Measures" in the Links Inside CMS section below to learn more about these specifications for eligible professionals and hospitals. More information on the final rule and fact sheets regarding meaningful use are available below.

To realize improved health care quality, efficiency and patient safety, the criteria for meaningful use will be staged in three steps over the course of the next five years. Stage 1 sets the baseline for electronic data capture and information sharing. Stage 2 (est. 2013) and Stage 3 (est. 2015) will continue to expand on this baseline and be developed through future rule making.

Incentive Program
Core and Menu Set

Challenges in EMR for physicians office

Reading bits and pieces of information from the internet and different viewpoints, it is quite evident that HIT implementation in a acute care hospital is not the same as implementing EMR for a physician's office.

Interestingly there are around 400 vendors( about 70 certified ones) for EMR. The average de-installation rate is close to 20%

While it is important for an EMR vendor to have a strong customer base and financial resources to keep updating features, it is important that they have the consulting skills and be able to help their clients derive business value from their IT investment. However smaller vendors have attractive pricing policy to compensate for lack of competencies.
EPIC systems for example is a product developed by the vendor internally and not put together through an acquisition plan. This gives them an advantage in terms of application lineage. It allows them to create lite version of the product to cater to a better range of customer needs.

According to Fox Group, 8 critical functions for a physicians office are
- Physician Inbasket
- Medcial Assistance Inbasket
- Patient scheduling
- Patient Check In
- Encounter documentation including workflows. CPT and DRG coding support
- Patient Check Out
- BIlling and Collections
- Patient Portal, reports etc

Moving from paper to computer is an important transition. Meaningful use increases in functionality and sophistication over period of time. Shift in incentives includes incentives payments, possible government financing. In order to have a operationally efficient EMR system and a "meaningful" the following are good steps to follow
- Observe a due diligence
- Assess operation consequences including changes in workflow
- Have a implementation plan and a team to carry it out
- Anticipate and handle disruption during implementation and conversion
- Balance between features. Dont overpurchase or be limited
- Get it right the first time is critical.