Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible healthcare professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified electronic health records (EHR) technology and use it to achieve specified objectives. Two regulations have been released, one of which defines the “meaningful use” objectives that providers must meet to qualify for the bonus payments. This year, the Medicare meaningful use implementation is expected to dominate the healthcare IT (HIT) industry. HIT providers are working to meet meaningful use criteria while government agencies work to implement the various EHR initiatives.
The meaningful use process has been broken into three stages and policy goals will be fully developed through building upon each stage. The stage one criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information. Starting April 18, providers will have access to information that will allow them to attest that their systems meet the criteria under this stage.
Stage two will expand upon the stage one criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. These changes will be reflected by a larger number of core objective requirements for stage two. CMS alsomay consider applying the criteria more broadly to the outpatient hospital settings (and not just the emergency department). Information exchange is a critical part of care coordination and we expect that the infrastructure will support greater requirements for using health information exchanges for stage two.
Stage three will focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data and improving population health outcomes.
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