What is Meaningful Use?

The HITECH provisions of the ARRA legislation will reward hospitals and physician practices for implementing a certified electronic health record (EHR). But you have to prove healthcare information technology (HIT) is making a difference. It's all about meaningful use.

The bar for demonstrating meaningful use will rise over time. The phased approach is focused on:

  • 2011 - Capturing and sharing data
  • 2013 - Advancing care processes with decision support
  • 2015 - Improving outcomes

The final Stage 1 meaningful use rules published on July 28, 2010, (applies to eligible hospitals and providers) include the following key changes:

  • Two categories of requirements are established (Core and Menu):
    1. The 15 Core set of objectives are not optional, and the specified measurement for each objective must be achieved.
    2. The Menu set of objectives allows eligible hospitals and physicians to select five of the 10 objectives based on their current stage of EHR implementation
  • Achievement levels of many of the objectives have been reduced.
  • Administrative and financial objectives (electronic claims submission and eligibility checking) have been deferred to Stage 2.
  • The proposed meaningful use rule limited all process and measurements to the inpatient setting (Point of Service Code 21). The final rule includes the Emergency Department for process and measurements (Point of Service Code 23) for eligible hospitals.

Other notable changes to the final vs. previously proposed meaningful use objectives:

Core:

  • For computerized provider order entry (CPOE), 30% of patients must have at least one medication order entered via CPOE (previously proposed for 10% of all clinical orders).
  • Security and Privacy requirements call for a security risk analysis, implementation of security updates and deficiency correction.
  • For e-prescribing, 40% of all permissible prescriptions written by an ambulatory physician must be transmitted electronically (reduced from 75%).
  • One clinical decision support rule must be implemented (five previously proposed).
  • Information exchange now required for quality measures reporting.
  • Providers must be able to electronically exchange key clinical information among providers (pass at least one test transaction).

Menu:

  • Incorporate lab results as structured data (at 40% level).
  • Generate lists of patients by specific conditions (at least one condition).
  • Provide patients with an electronic copy of their health information upon request for more than 50% of all patients within 3 business days (previously proposed for 80% within 48 hours).
  • Provide clinical summaries to patients for more than 50% of all offices visits within 3 business days (reduced from 80%).
  • New: Use the EHR to identify patient-specific education resources (10% level).
  • New: Record advance directives for patients over 65 (for more than 50% of patients).
  • Perform medication reconciliation between care settings (for more than 50% of transitions of care).

Learn more about what you can be doing today to advance your EHR initiative.