Enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA), the Health Information Technology for Economic and Clinical Health (HITECH) Act propels the adoption of Electronic Health Records (EHRs) by providing financial incentives and penalties under Medicare and Medicaid to hospitals and eligible providers who demonstrate meaningful use of certified EHR technology.
On July 28, 2010, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator (ONC) published the Stage 1 criteria for the meaningful use final rule that is aimed to help improve health outcomes, increase safety, and contain health care costs through increased use of certified (EHR) technology. Criteria for stages 2 and 3 have not yet been published.
Three main components of Meaningful Use are specified in the Meaningful Use Stage 1 Final Rule:
- The use of a certified Electronic Health Record (EHR) in a meaningful manner
- The use of certified EHR technology for electronic exchange of health information
- The use of certified EHR technology to submit clinical quality data and other measures
The meaningful use of EHRs intended by the US government incentives is categorized as follows:
- Improve care coordination
- Improve quality, safety, efficiency and reduce healthcare disparities
- Engage patients and their families
- Improve population and public health
- Ensure adequate privacy and security
The first steps in achieving meaningful use are to have a certified electronic health record (EHR) and to be able to demonstrate that it is being used to meet the requirements. Stage 1 contains 25 objectives/measures for Eligible Providers (EPs) and 24 objectives/measures for eligible hospitals. The objectives/measures have been divided into a core set and menu set. EPs and eligible hospitals must meet all objectives/measures in the core set (15 for EPs and 14 for eligible hospitals).
Several of the MU objectives/measures will have a significant impact on physicians. In addition to CPOE, which is outlined in detail below, physicians will be required to maintain an up to date problem list of current and active diagnoses as structured data. Another requirement, electronic medication reconciliation, will be dramatically improved in Cerner with the CPOE roll-out. Also, MU requires changes to physician documentation, especially at patient discharge, which will provide for the foundation of the Continuity of Care Document (CCD)
Eligible Provider Information from CMS
Eligible Hospital Information from CMS