The EHR and Meaningful Use
This is the second part in a short series about Electronic Health Records (EHRs), meaningful use, and the connection between EHRs and librarians.
As mentioned in the previous post in this series, the rate of adoption of EHRs by healthcare practitioners has been slow. As a result, the Health Information Technology for Economic and Clinical Health (HITECH) Act was created as part of the American Recovery and Reinvestment Act (ARRA) of 2009. The HITECH Act authorized the Centers for Medicare & Medicaid Services (CMS) to provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals (CAHs) that implement EHRs and are able to demonstrate meaningful use. Under the ARRA and HITECH Act, meaningful encompasses the following three components:
- The use of a certified EHR in a meaningful manner.
- The electronic exchange of health information to improve quality of health care.
- The use of certified EHR technology to submit clinical quality and other measure.
In 2010, the CMS published a final rule that established three stages for supporting eligible professionals, eligible hospitals, and CAHs that plan to implementing EHRs in a way that will meet meaningful use criteria and objectives (to see a detailed timetable of the three stages visit HealthIT.gov’s page on meaningful use). Currently, only Stage 1 has been put into effect, with Stage 2 to begin sometime in 2014.
Each stage requires eligible professionals, eligible hospitals, and CAHs to meet a number of core and menu set objectives in order to achieve meaningful use. For example, in Stage 1, eligible professionals are required to meet 15 core objectives and 5 out of 10 menu set objectives found here. Also as part of the meaningful use core objectives, eligible professionals and hospitals are required to report on clinical quality measures (CQMs) which are tools that “help measure and track the quality of healthcare services provided by eligible professionals, eligible hospitals and critical access hospitals within our health care system” (CMS.gov, Clinical Quality Measures http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf)
To find more information on how meaningful use and EHRs are being utilized, search PubMed using the Structured Evidence Query for HealthyPeople2020 Objective HC/HIT-11.
Centers for Medicare & Medicaid Services: EHR Incentive Program Final Rule
Centers for Medicare & Medicaid Services : Meaningful Use
HRSA Meaningful Use Stage 1 Clinical Quality Measures for the Safety Net Community