We have been discussing Meaningful Use for some time now, and several of our readers have been asking for us to go back to the basics to explain in broad terms what it is, how it impacts healthcare, and what are the top things that individuals and organizations need to know. In response to this request, we are pleased to present this post where we will go back and explain the basics, EHR Meaningful Use 101 so to speak. We hope that you find this helpful!
These meaningful use standards mean that it is not enough for healthcare organizations to utilize Electronic Health Records, but that they must do so in a way which accomplishes the above objectives in a concrete way which is measurable and improves the overall care experience. EHRs must be utilized in a manner which improves quality, safety and efficiency. This can
Mean utilizing EHRs to coordinate care between providers or to monitor care more efficiently to avoid over-medication, or different practitioners prescribing non compatible medication. It also means that practices utilizing EHRs must have to improve efficiency through their utilization. Paper records were previously cumbersome, and missed not only the capture of some critical data, but the sharing of that data between organizations and systems. The transition to medical based records promises to eliminate duplicate entries from a data administration point of view, and streamline the patient record keeping process.
Meaningful Use And Its Implications For Your Practice
EHRS must be utilized to fully engage patients and families. This means allowing care to be more patient centered, or driven by the patients preferences, which can be recorded in effective EHR databases. Some organizations may wish to implement new clinical processes and improvements based on EHR information such as outreach programs for those with chronic conditions, or increased follow up for those patients who often miss appointments.
When EHRs aim to improve care coordination and public health, they are referring to a new ability for providers to collaborate regarding patient care to an extent never before possible with paper records. A primary care provider and mental health provider may utilize EHRs to fully treat a patients conditions in an integrated care approach aided by the technology that EHRs contain. No longer will care be siloed between specific providers. EHRs will allow for increased communication, coordination, and collaboration that will enable physicians to get a total picture of a patients condition and prior care, and thus be empowered to treat them more effectively.
Finally, EHRs must be able to fully support the protection of private patient information. This means that although EHRs will be utilized to detect large population trends related to care, and will have the ability to allow for increased integration of care between providers, a persons private and protected healthcare information must remain just that….private and protected. Organizations may not share any health records, including Electronic Health Records, without patient approval, and standards of confidentiality related to Electronic Health Records are the same or more stringent than the standards for traditional records.Meaningful Use Definition, Stages 1, 2 & 3 'Meaningful Use' is a term used in relation to the Medicare and Medicaid EHR Incentive Programs (now known as the Medicare Promoting Interoperability Program) established by CMS in 2011. Compliance with meaningful use requires the use of certified EHR technology in a meaningful manner (for instance, electronic prescribing) thereby ensuring that it is connected in a manner that provides for the electronic exchange of health information to improve the quality of care. The provider must use the certified EHR technology and submit information on quality of care and other measures to the Secretary of Health & Human Services (HHS). ‘Meaningful Use’ is the general term for the Center of Medicare and Medicaid’s (CMS’s) electronic health record (EHR) incentive programs that provide financial benefits to healthcare providers who use appropriate EHR technologies in meaningful ways; ways that benefit patients and providers alike. The Medicare and CHIP Reauthorization Act of (MACRA) 2015 established the Quality Payment Program (QPP). The Merit-based Incentive Payment System (MIPS) is one of two ways that eligible professionals and hospitals can participate in QPP. Effect of MACRA on Meaningful Use The Medicare EHR Incentive Program, aka Meaningful Use, was transitioned to become one of the four components of the new MIPS. MIPS consolidates three fee-for-service programs – the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier Program(VBM) and the Medicare Electronic Health Records (EHR) Incentive Program which has been renamed as the Promoting Interoperability category in 2018 – into one fee-for-value program. Image Source: https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use With the MACRA Promoting Interoperability category came a stronger push for interoperability. Participants must report the required measures under each of the four objectives below, or claim exclusions if applicable: ePrescribing, Health Information Exchange Provider to Patient Exchange Public Health and Clinical Data Exchange As noted, these objectives are similar to the requirements for the Meaningful Use program. HITECH Act of 2009 Commenced Push for Adoption and Meaningful Use of EHR The American Recovery and Reinvestment Act (ARRA) of 2009 was primarily intended to help the country recover from the Great Recession of 2008. However, it also contained measures aimed at providing investments in health and science technology, among others. As part of ARRA, the Health Information Technology for Economic and Clinical Health Act (HITECH) had a major impact on healthcare as it pushed for the nationwide adoption and “meaningful use” of electronic health records (EHRs). Meaningful Use and Health Outcomes According to the Centers for Disease Control (CDC), the concept of “meaningful” use or MU is anchored on five health outcomes pillars. These are: Improving quality, safety, efficiency, and reducing health disparities Engage patients and families in their health Improve care coordination Improve population and public health Ensure adequate privacy and security protection for personal health information The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health IT have been leading MU’s phased implementation, which occurred in stages. The ONC has noted on its website that the Advancing Care Information category (which in 2018 was renamed Promoting Interoperability or PI) within the Merit-Based Incentive Payment System or MIPS supplants meaningful use. However, it would still be extremely useful to have a familiarity with the background and evolution of MU to better understand what’s coming in the future. Meaningful Use Stages According to the CDC’s MU website, “in order to encourage widespread EHR adoption, promote innovation and to avoid imposing excessive burden on healthcare providers, meaningful use was showcased as a phased approach, which is divided into three stages.” This incremental implementation began with data capture and sharing in 2011 and moved up to advanced clinical processes in 2013 and then included improved outcomes in 2015. What is Stage 1 of Meaningful Use? For Meaningful Use Stage 1, the 15 core objectives for Eligible Professionals (EPs) were: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Implement drug-drug and drug-allergy checks. Maintain an up-to-date problem of current and active diagnoses Maintain active medication list Maintain active medication allergy list Generate and transmit permissible prescriptions electronically (eRx). Record patient demographics: sex, preferred language, race, ethnicity, and date of birth. Record vital signs and chart changes in the following: height, weight, blood pressure, body mass index (BMI), growth charts for children. Record smoking status for patients 13 years old or older. On request, provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies). Provide clinical summaries for patients for each office visit. Implement capability to exchange key clinical information among providers and patient authorized entities electronically. Implement one clinical decision support rule along with the ability to track compliance with the rule. Implement systems to protect privacy and security of patient data in EHR Report clinical quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, the States). The 10 Menu Set Objectives for EPs, which they must report at least 5 of, were: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach. Send reminders to patients per patient preference for preventive/follow-up care. (Patient preference refers to the patient's choice of delivery method between internet based delivery or delivery not requiring internet access.) Incorporate clinical lab-test results into EHR as structured data. Implement drug-formulary checks Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 4 business days of the information being available to the EP either through the receipt of final lab results or a patient interaction that updates the EP's knowledge of the patient's health. (Electronic access may be provided by a number of secure electronic methods like PHR, patient portal, CD, USB drive). User certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. The EP who receives a patient from another setting of care or
Electronic Health Record
EHRS must be utilized to fully engage patients and families. This means allowing care to be more patient centered, or driven by the patients preferences, which can be recorded in effective EHR databases. Some organizations may wish to implement new clinical processes and improvements based on EHR information such as outreach programs for those with chronic conditions, or increased follow up for those patients who often miss appointments.
When EHRs aim to improve care coordination and public health, they are referring to a new ability for providers to collaborate regarding patient care to an extent never before possible with paper records. A primary care provider and mental health provider may utilize EHRs to fully treat a patients conditions in an integrated care approach aided by the technology that EHRs contain. No longer will care be siloed between specific providers. EHRs will allow for increased communication, coordination, and collaboration that will enable physicians to get a total picture of a patients condition and prior care, and thus be empowered to treat them more effectively.
Finally, EHRs must be able to fully support the protection of private patient information. This means that although EHRs will be utilized to detect large population trends related to care, and will have the ability to allow for increased integration of care between providers, a persons private and protected healthcare information must remain just that….private and protected. Organizations may not share any health records, including Electronic Health Records, without patient approval, and standards of confidentiality related to Electronic Health Records are the same or more stringent than the standards for traditional records.Meaningful Use Definition, Stages 1, 2 & 3 'Meaningful Use' is a term used in relation to the Medicare and Medicaid EHR Incentive Programs (now known as the Medicare Promoting Interoperability Program) established by CMS in 2011. Compliance with meaningful use requires the use of certified EHR technology in a meaningful manner (for instance, electronic prescribing) thereby ensuring that it is connected in a manner that provides for the electronic exchange of health information to improve the quality of care. The provider must use the certified EHR technology and submit information on quality of care and other measures to the Secretary of Health & Human Services (HHS). ‘Meaningful Use’ is the general term for the Center of Medicare and Medicaid’s (CMS’s) electronic health record (EHR) incentive programs that provide financial benefits to healthcare providers who use appropriate EHR technologies in meaningful ways; ways that benefit patients and providers alike. The Medicare and CHIP Reauthorization Act of (MACRA) 2015 established the Quality Payment Program (QPP). The Merit-based Incentive Payment System (MIPS) is one of two ways that eligible professionals and hospitals can participate in QPP. Effect of MACRA on Meaningful Use The Medicare EHR Incentive Program, aka Meaningful Use, was transitioned to become one of the four components of the new MIPS. MIPS consolidates three fee-for-service programs – the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier Program(VBM) and the Medicare Electronic Health Records (EHR) Incentive Program which has been renamed as the Promoting Interoperability category in 2018 – into one fee-for-value program. Image Source: https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use With the MACRA Promoting Interoperability category came a stronger push for interoperability. Participants must report the required measures under each of the four objectives below, or claim exclusions if applicable: ePrescribing, Health Information Exchange Provider to Patient Exchange Public Health and Clinical Data Exchange As noted, these objectives are similar to the requirements for the Meaningful Use program. HITECH Act of 2009 Commenced Push for Adoption and Meaningful Use of EHR The American Recovery and Reinvestment Act (ARRA) of 2009 was primarily intended to help the country recover from the Great Recession of 2008. However, it also contained measures aimed at providing investments in health and science technology, among others. As part of ARRA, the Health Information Technology for Economic and Clinical Health Act (HITECH) had a major impact on healthcare as it pushed for the nationwide adoption and “meaningful use” of electronic health records (EHRs). Meaningful Use and Health Outcomes According to the Centers for Disease Control (CDC), the concept of “meaningful” use or MU is anchored on five health outcomes pillars. These are: Improving quality, safety, efficiency, and reducing health disparities Engage patients and families in their health Improve care coordination Improve population and public health Ensure adequate privacy and security protection for personal health information The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health IT have been leading MU’s phased implementation, which occurred in stages. The ONC has noted on its website that the Advancing Care Information category (which in 2018 was renamed Promoting Interoperability or PI) within the Merit-Based Incentive Payment System or MIPS supplants meaningful use. However, it would still be extremely useful to have a familiarity with the background and evolution of MU to better understand what’s coming in the future. Meaningful Use Stages According to the CDC’s MU website, “in order to encourage widespread EHR adoption, promote innovation and to avoid imposing excessive burden on healthcare providers, meaningful use was showcased as a phased approach, which is divided into three stages.” This incremental implementation began with data capture and sharing in 2011 and moved up to advanced clinical processes in 2013 and then included improved outcomes in 2015. What is Stage 1 of Meaningful Use? For Meaningful Use Stage 1, the 15 core objectives for Eligible Professionals (EPs) were: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Implement drug-drug and drug-allergy checks. Maintain an up-to-date problem of current and active diagnoses Maintain active medication list Maintain active medication allergy list Generate and transmit permissible prescriptions electronically (eRx). Record patient demographics: sex, preferred language, race, ethnicity, and date of birth. Record vital signs and chart changes in the following: height, weight, blood pressure, body mass index (BMI), growth charts for children. Record smoking status for patients 13 years old or older. On request, provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies). Provide clinical summaries for patients for each office visit. Implement capability to exchange key clinical information among providers and patient authorized entities electronically. Implement one clinical decision support rule along with the ability to track compliance with the rule. Implement systems to protect privacy and security of patient data in EHR Report clinical quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, the States). The 10 Menu Set Objectives for EPs, which they must report at least 5 of, were: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach. Send reminders to patients per patient preference for preventive/follow-up care. (Patient preference refers to the patient's choice of delivery method between internet based delivery or delivery not requiring internet access.) Incorporate clinical lab-test results into EHR as structured data. Implement drug-formulary checks Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 4 business days of the information being available to the EP either through the receipt of final lab results or a patient interaction that updates the EP's knowledge of the patient's health. (Electronic access may be provided by a number of secure electronic methods like PHR, patient portal, CD, USB drive). User certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. The EP who receives a patient from another setting of care or
Electronic Health Record
EHRS must be utilized to fully engage patients and families. This means allowing care to be more patient centered, or driven by the patients preferences, which can be recorded in effective EHR databases. Some organizations may wish to implement new clinical processes and improvements based on EHR information such as outreach programs for those with chronic conditions, or increased follow up for those patients who often miss appointments.
When EHRs aim to improve care coordination and public health, they are referring to a new ability for providers to collaborate regarding patient care to an extent never before possible with paper records. A primary care provider and mental health provider may utilize EHRs to fully treat a patients conditions in an integrated care approach aided by the technology that EHRs contain. No longer will care be siloed between specific providers. EHRs will allow for increased communication, coordination, and collaboration that will enable physicians to get a total picture of a patients condition and prior care, and thus be empowered to treat them more effectively.
Finally, EHRs must be able to fully support the protection of private patient information. This means that although EHRs will be utilized to detect large population trends related to care, and will have the ability to allow for increased integration of care between providers, a persons private and protected healthcare information must remain just that….private and protected. Organizations may not share any health records, including Electronic Health Records, without patient approval, and standards of confidentiality related to Electronic Health Records are the same or more stringent than the standards for traditional records.Meaningful Use Definition, Stages 1, 2 & 3 'Meaningful Use' is a term used in relation to the Medicare and Medicaid EHR Incentive Programs (now known as the Medicare Promoting Interoperability Program) established by CMS in 2011. Compliance with meaningful use requires the use of certified EHR technology in a meaningful manner (for instance, electronic prescribing) thereby ensuring that it is connected in a manner that provides for the electronic exchange of health information to improve the quality of care. The provider must use the certified EHR technology and submit information on quality of care and other measures to the Secretary of Health & Human Services (HHS). ‘Meaningful Use’ is the general term for the Center of Medicare and Medicaid’s (CMS’s) electronic health record (EHR) incentive programs that provide financial benefits to healthcare providers who use appropriate EHR technologies in meaningful ways; ways that benefit patients and providers alike. The Medicare and CHIP Reauthorization Act of (MACRA) 2015 established the Quality Payment Program (QPP). The Merit-based Incentive Payment System (MIPS) is one of two ways that eligible professionals and hospitals can participate in QPP. Effect of MACRA on Meaningful Use The Medicare EHR Incentive Program, aka Meaningful Use, was transitioned to become one of the four components of the new MIPS. MIPS consolidates three fee-for-service programs – the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier Program(VBM) and the Medicare Electronic Health Records (EHR) Incentive Program which has been renamed as the Promoting Interoperability category in 2018 – into one fee-for-value program. Image Source: https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use With the MACRA Promoting Interoperability category came a stronger push for interoperability. Participants must report the required measures under each of the four objectives below, or claim exclusions if applicable: ePrescribing, Health Information Exchange Provider to Patient Exchange Public Health and Clinical Data Exchange As noted, these objectives are similar to the requirements for the Meaningful Use program. HITECH Act of 2009 Commenced Push for Adoption and Meaningful Use of EHR The American Recovery and Reinvestment Act (ARRA) of 2009 was primarily intended to help the country recover from the Great Recession of 2008. However, it also contained measures aimed at providing investments in health and science technology, among others. As part of ARRA, the Health Information Technology for Economic and Clinical Health Act (HITECH) had a major impact on healthcare as it pushed for the nationwide adoption and “meaningful use” of electronic health records (EHRs). Meaningful Use and Health Outcomes According to the Centers for Disease Control (CDC), the concept of “meaningful” use or MU is anchored on five health outcomes pillars. These are: Improving quality, safety, efficiency, and reducing health disparities Engage patients and families in their health Improve care coordination Improve population and public health Ensure adequate privacy and security protection for personal health information The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health IT have been leading MU’s phased implementation, which occurred in stages. The ONC has noted on its website that the Advancing Care Information category (which in 2018 was renamed Promoting Interoperability or PI) within the Merit-Based Incentive Payment System or MIPS supplants meaningful use. However, it would still be extremely useful to have a familiarity with the background and evolution of MU to better understand what’s coming in the future. Meaningful Use Stages According to the CDC’s MU website, “in order to encourage widespread EHR adoption, promote innovation and to avoid imposing excessive burden on healthcare providers, meaningful use was showcased as a phased approach, which is divided into three stages.” This incremental implementation began with data capture and sharing in 2011 and moved up to advanced clinical processes in 2013 and then included improved outcomes in 2015. What is Stage 1 of Meaningful Use? For Meaningful Use Stage 1, the 15 core objectives for Eligible Professionals (EPs) were: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Implement drug-drug and drug-allergy checks. Maintain an up-to-date problem of current and active diagnoses Maintain active medication list Maintain active medication allergy list Generate and transmit permissible prescriptions electronically (eRx). Record patient demographics: sex, preferred language, race, ethnicity, and date of birth. Record vital signs and chart changes in the following: height, weight, blood pressure, body mass index (BMI), growth charts for children. Record smoking status for patients 13 years old or older. On request, provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies). Provide clinical summaries for patients for each office visit. Implement capability to exchange key clinical information among providers and patient authorized entities electronically. Implement one clinical decision support rule along with the ability to track compliance with the rule. Implement systems to protect privacy and security of patient data in EHR Report clinical quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, the States). The 10 Menu Set Objectives for EPs, which they must report at least 5 of, were: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach. Send reminders to patients per patient preference for preventive/follow-up care. (Patient preference refers to the patient's choice of delivery method between internet based delivery or delivery not requiring internet access.) Incorporate clinical lab-test results into EHR as structured data. Implement drug-formulary checks Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 4 business days of the information being available to the EP either through the receipt of final lab results or a patient interaction that updates the EP's knowledge of the patient's health. (Electronic access may be provided by a number of secure electronic methods like PHR, patient portal, CD, USB drive). User certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. The EP who receives a patient from another setting of care or
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