In mid July, 2010, The Centers for Medicare and Medicaid Services and the National Coordinator for Health Information Technology issued the Final Rule covering the HITECH Act's Electronic Health Records Incentive Program. Among those issues finalized was the definition of EHR Meaningful Use Stage 1 Criteria.
While several of the larger, more comprehensive systems addressed many of the final EHR Meaningful Use Stage 1 requirements, very few Electronic Health Record Systems addressed all of the requirements initially. Indeed, some of the requirements are not actually functions of an EHR system, such as conducting a HIPAA Security Risk Assessment.
The first draft of the meaningful use criteria was published in June 2009 by the Meaningful Use Workgroup of the Health Information Technology Policy Committee, the advisory committee established to propose regulations and policies to implement the HITECH Act. An Interim Final Draft rule was published in January 2010.
Medicaid Meaningful Use Stage 2 Objective 7: Medication Reconciliation
When the initial draft of the Meaningful Use Criteria was released many found it surprising that there was less emphasis on the traditional functions of an EHR system, e.g., provider documentation and electronic claims submission, and more emphasis on patient access.
The Objectives are described for Eligible Providers and for Hospitals. There are two groups of objectives, consisting of 15 “Core Objectives”, plus a Menu of 10 additional features, of which providers must chose at least 5 to implement.
The list for hospitals is the same, except they must provide patients with an electronic copy of their discharge instructions upon request, vs. a summary of each office visit.
Ehr Meaningful Use Criteria: Overview Including 15 Core Objectives
The Meaningful Use Criteria objectives are accompanied by Measures – standards of performance of use for each Objective. Thus, Eligible Providers must have an EHR system with the capability of meeting the meaningful use criteria objectives, and must actually use it to certain levels, to qualify for the incentives in the HITECH Act.
Other aspects of the HITECH Act necessary for the Meaningful Use Incentive program have also been completed. Five organizations have been certified to evaluate and certify EHR applications as “Certified EHR Technology”. Including variants of the same basic system, over 1700 EHR applications have received certification as a complete or modular EHR for ambulatory care practice settings. Only providers utilizing a complete EHR product can attest to meaningful use of certified EHR technology.
On August 23, 2012, CMS issued the final rule on Meaningful Use Stage 2 criteria. This rule covers the Stage 2 criteria for Eligible Professionals (EPs), Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) for purposes of Medicare or Medicaid incentive payments for meaningful use of certified EHR technology.
Ehr Internal Messaging, Secure Messaging And Stage 2 Meaningful Use
The Stage 2 objectives and measures expand on the Meaningful Use Stage 1 objectives, transitioning many of the Menu objectives into Core objectives and increasing the thresholds for performance.
The Meaningful Use Stage 1 objectives will be relevant for years to come. The Stage 2 Final Rule anticipates providers may not adopt Certified EHR Technology for several years, and may only attest (or be audited!) as meeting Meaningful Use Stage 1 Criteria. Providers who delay in adopting EHR Technology may find the objectives and measures – and vendor capabilities for demonstrating meaningful use - have been overtaken by changes in Stage 2 and Stage 3, making meaningful use against Stage 1 criteria difficult to prove.
For more information on meaningful use criteria and many other issues related to EHR systems, contact us so that we can help you find the answers to your questions. We think you'll be glad you did.At some point the decision to embrace electronic health records in your practice will be a matter not of if, but of when. For a number of reasons (or more precisely, a reason of numbers, as in dollars), that decision point should be sooner rather than later, especially if a significant number of your patients are on Medicare or Medicaid. This article will explain the timeline and the rationale for why ophthalmologists need to start learning about concepts such as meaningful use.
Ep Meaningful Use Criteria
The Centers for Medicare & Medicaid Services is currently offering $44, 000 in incentives per physician over the next five years to help offset the cost of purchasing an EHR system. However, to take full advantage of these incentives, you will need to get started soon. In 2015, the incentives will be gone, and physicians will begin being penalized by CMS if they are not meeting meaningful use requirements, starting with a 1-percent penalty that will increase to 3 percent by 2017 and potentially reach a maximum of 5 percent by 2019 if adoption rates are not high enough.
“This is not a mandatory thing from the government, so no one will go to jail, ” says Peter J. Polack, MD, co-author of
, in practice in Ocala, Fla. “But they will incur up to a maximum 5 percent penalty. That may not sound like a lot, but by the time you combine a 0 percent increase in reimbursement with whatever the inflation rate is that year, and then you add a 5 percent cut on top of that, those things start to add up. It behooves practices to seriously look in the direction of EHR.”
Meaningful Use Compliance And Reporting
The purpose behind this movement toward electronic health records is to improve the exchange and use of health-care information among different physicians and between physicians and patients, according to Michael Chiang, MD, a professor of ophthalmology and medical informatics at Oregon Health and Science University and chair of the AAO Medical Information Technology Committee. “It is that information transfer that is going to hopefully allow people to make better decisions about health care and therefore improve the quality of care, ” he says. “It’s about better quality and not just about using the technology.”
In addition to improving quality of care, EHRs are a way for the government and private insurance carriers to monitor the practice of medicine. “If the government wants to find out how we are taking care of patients and if we are in compliance, our office would have to be audited, and someone would have to look through our paper records, ” Dr. Polack says. “Now, fast-forward to a time when all physicians are using EHRs. Instead of coming to your office and poring through a whole bunch of paper records, we are giving our information to them, and we now have proof that we are doing everything right.”
According to Dr. Chiang, the move toward EHRs began years ago. “George Bush, in his 2004 State of the Union Address, established a goal that all Americans would have access to electronic health records within the next 10 years. The Department of Health and Human Services put out a 10-year plan as to how to accomplish that, but there really wasn’t much money allocated to that sort of vision, ” he explains.
Meaningful Use 2016
In 2009, as part of the American Recovery and Reinvestment Act (also called the Stimulus Package), there was an act called the HITECH Act. The purpose of this act was to speed up adoption of health-care information technology, and $27 billion was allocated to that purpose. “This is essentially a national plan for driving the adoption of EHRs based on financial incentives, ” Dr. Chiang adds.
Under the current plan, to meet meaningful use requirements, ophthalmologists “need to show that they are using certified EHR technology in ways that can be measured significantly in quality and in quantity, ” according to the CMS.
Meaningful use criteria will be implemented in three stages during the next five years. According to the CMS, Stage 1, which should be implemented during 2011 and 2012, “sets the baseline for electronic data capture and information sharing.” Stages 2 and 3, which are expected to be implemented in 2013 and 2015, respectively, will continue to expand on this baseline.
What Is Meaningful Use (mu)?
However, even if ophthalmologists cannot implement Stage 1 during 2011 or 2012, they can still receive a portion of the incentives. They will just need to compress the timeline.
According to the current timeline, if ophthalmologists implement and meet Stage 1 criteria in 2011, they would be expected to go to Stage 2 in 2013 and Stage 3 in 2015. “If you started in 2011, you’d be expected to move from Stage 1 to Stage 3 over five years. If you went live in 2012, Stage 1 would be 2012, Stage 2 would be 2013, and Stage 3 would be 2015. In other words, you’d be required to advance more quickly. If you wait until 2014, you would need to meet Stage 1 criteria in 2014, Stage 2 criteria in 2015, and Stage 3 criteria in 2016. So, the timeline gets compressed the longer you wait, ” Dr. Chiang says.
In addition to the timeline being compressed, the incentive payment goes down. If ophthalmologists meet meaningful use criteria in 2011 or 2012, the total incentive payment is $44, 000, but if they wait until 2013, the total incentive payment goes down to $39, 000. And, if they wait until 2014, it goes down to $24, 000. If they wait until 2015, they not only don’t get any incentive payment, but they will incur a Medicare penalty.
Key Meaningful Use Terms
To meet the requirements for Stage 1
