HHSC defines “meaningful use”
of electronic health records

posted 10.07.10

After a year of waiting, the U.S. Health and Human Services Commission clarified a stipulation that will determine which physicians qualify for payment under the federal stimulus bill. Within the American Recovery and Reinvestment Act of 2009 is the Health Information Technology for Economic and Clinical Health Act, or HITECH. This section of the law grants physicians access to Medicare and Medicaid incentive payments to purchase and operate electronic health record technology. However, physicians must meet certain specifications to qualify, one of which is proving that they are “meaningful users” of a certified EHR.

The incentive payments sound noble and effective when simply stated. However, when they were initially announced, many physicians were concerned with the short timeline to implement EHR technology by 2015. Questions of costs and funding soon followed. To answer the 2,000 comments the Centers for Medicare and Medicaid Services received from physicians about the incentive announcement, HHSC distributed a press release July 13, with the steps required to receive payments, as well as defining “meaningful use.”

“Meaningful use” is defined through three requirements. First, physicians must use certified EHR technology in a meaningful manner, operating the technology to maintain records, provide e-prescriptions, and other functions. The EHR must also allow for electronic exchange of information. Under this requirement, the door is opened to communication between other physicians or specialists sharing health information to improve health care quality and ultimately reduce errors and duplication of services. Lastly, meaningful EHR operation allows physicians to report clinical quality measures.

By following the “meaningful use” rule, $27 billion in incentive payments are available over the span of 10 years. Each physician may receive up to $44,000 in Medicare aid and $63,750 under Medicaid, distributed in increments each year over five years in the incentive program. This funding, of course, goes towards purchasing and maintaining EHR technology and training staff on its use. The ultimate goal is to create a uniform electronic system. In the press release, David Blumenthal, M.D., national coordinator for health information technology, said this represents a defining moment in the industry. “This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care.”

To qualify for the incentive payments, physicians and hospitals must adhere to meaningful use standard of their certified EHR technology each year they participate in the program. This multi-year program will increasingly raise the bar on standards in subsequent years.

Stage 1 begins the incentive program in 2011, where the standards of “meaningful use” are set and eligible participants can begin receiving payments. To receive payment, physicians must complete 20 of 25 meaningful use objectives. These objectives are specific data that physicians must include in their EHR systems, some of which include medication lists, identifying smoking status, and generating e-prescriptions. To increase health care quality over time, the meaningful use criteria will be staged in a series of three raised steps until 2015.

Blumenthal said the technological transition will not be easy, but maintains the adjustment is necessary. “Health care is finally making the technology advances that other sectors of our economy began to undertake years ago. These changes will be challenging for clinicians and hospitals, but the time has come to act. Adoption and meaningful use of EHRs will help providers deliver better and more effective care, and the benefits for patients and providers alike will grow rapidly over time.”

To learn more about the EHR incentive programs, go to www.cms.gov/EHRIncentivePrograms. To read the U.S. Health and Human Services Commission July 13 press release, go to www.hhs.gov/news/press/2010pres/07/20100713a.html.

By Melissa Ayala, TAFP publications intern - Fall 2010