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What is meaningful use and how might it affect my library?

“Meaningful use” is a phrase that is gaining national momentum as national healthcare reform moves forward. But what is meaningful use, anyway? No, it’s not evidence based health care, although there is a logical tone to that analogy. Instead, meaningful use refers to using electronic health records (EHRs) to achieve improvements in health care. To determine what constitutes meaningful use, the Department of Health and Human Services (DHHS) released a regulation that specified meaningful use objectives for the first two years (2011 and 2012) of the new healthcare reform act. Meeting the specified objectives will entitle a physician or practice group to receive financial incentives. Not meeting the objectives will eventually lead to fines.

David Blumenthal, M.D., the DHHS National Coordinator for Health Information Technology, with his colleagues, has published an article, ‘The “Meaningful Use” Regulation for Electronic Health Records’, in the August 5, 2010, issue of New England Journal of Medicine (PMID 20647183). The article describes two types of objectives: core objectives, all of which must be met, and menu items, of which 5 of 10 must be implemented during 2011-2012. In future years, additional objectives will be added, and the number of required objectives will grow.

Core objectives at present include essential items like patients’ vital signs, allergies, active medications, and current diagnoses. The value of EHRs will grow as physicians use these systems to enter clinical orders and medication prescriptions. When orders are entered electronically, computer technology can help improve decisions and reduce errors by applying clinical logic in relation to the patient data. Essential to this logic are the data standards for diagnostic codes and procedures which has been a primary focus of the National Library of Medicine (NLM) through projects such as the Unified Medical Language System (UMLS). These data standards serve as the foundation for systems of electronic health records to communicate with each other.

The menu of 10 objectives, for which 5 must be implemented, includes “using certified EHR technology to identify patient-specific education resources and provide those to the patient as appropriate”. This is an interesting objective which also ties into NLM’s assets, specifically MedlinePlus. You may remember discussion about this at MLA 2010. At the NLM theater booth presentation on MedlinePlus, although the major news at the time was screen redesign, another project, MedlinePlus Connect, was mentioned. More information about MedlinePlus Connect was provided at the NLM Update, including the fact that MedlinePlus Connect is piloting linking with the EHR via the HL7 Infobutton with Epic’s MyChart, Epic’s solution for patient access to their health records. Thus, when a patient reads his electronic health record, he can click on a link from his diagnosis (the HL7 Infobutton) and be directed to MedlinePlus page on that topic.

The National Library of Medicine is currently developing the MedlinePlus Connect project and piloting it with a small group of users. When MedlinePlus Connect is widely available later this year, the National Library of Medicine will make announcements via library and health IT forums, listservs, and publications. At that time, the National Library of Medicine will also post documentation on the MedlinePlus web site. Stay tuned for more information.

So, how can you help your hospital? You can let them know about MedlinePlus Connect! Be sure to tell them that there will be no charge to link to it. It is FREE! There will undoubtedly be many financial issues that a hospital must consider when implementing the EHR. Wouldn’t you like to tell them one way they can save money?

More information about meaningful use is available on the Electronic Health Records and Meaningful Use page of the Health IT web site.Please feel free to contact us for more information.

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