What You Need To Know About Meaningful Use

by Jason E. Lopata, Esq.

You’ve heard the term “meaningful use” being used – but what does it mean? The Centers for Medicare & Medicaid Services (CMS) have issued new regulations that are designed to lay the groundwork for physicians and hospitals to further implementation and use of electronic health records (EHR).  Specifically, the CMS has issued a proposed rule detailing what constitutes “meaningful use” of the new technologies available for the maintenance and protection of EHR.   These rules were posted on January 13, 2010 and will be open for public comment for 60 days before being finalized.  The first stage of the incentives program is scheduled to start in 2011.

As part of the American Recovery and Reinvestment Act of 2009, Medicare wanted to reward “meaningful users,” defined as any eligible professional who “demonstrates use of certified EHR technology in a meaningful manner.”  The regulations are designed to improve the quality of health care by promoting care coordination and the use of certified EHR technology.  Part of its intent is also to bring about standard formats for clinical summaries and prescriptions, as well as standard terms being used to describe clinical issues nationwide.  Lastly, it seeks to increase the security measures used to transmit personal health information over the Internet.

So why is this important now, if the incentives program doesn’t begin until 2011?  In a word…money!  Don’t wait until next year to have a plan in place.  The incentives currently are set at reimbursements (over a period of up to 6 years) totaling $44,000 under Medicare and up to $63,750 under the Medicaid programs (however, qualified professionals would not be able to receive monies under both programs).   Even if you’re not interested in working toward those incentive dollars (and frankly, why wouldn’t you?), eligible medical professionals will start being penalized, in 2015, for failure to meet the standards of “meaningful use.”  So as you can see, failure to “get with the program” will have a negative financial impact on your practice.

While the CMS is still defining what will constitute “meaningful use,” it currently has outlined 25 objectives for physicians (23 for hospitals) which will be measured starting in 2011.  These include the use of computerized provider order entries, having the ability for a 48 hour turnaround on patient medical record requests, and maintaining a certain percentage of clinical lab tests in electronic format.  Other criteria will include checking public and private insurance eligibility electronically, submitting claims electronically, and maintaining active medications lists.

Where do you begin to become a “meaningful user”?  If you already have an EHR system in place, an assessment should be done to see if it means the requirement of “meaningful use,” using as many of the criteria that the CMS has published.  If you do not yet have any form of EHR system in your practice, physicians should immediately start their due diligence on competent vendors able to bring EHR systems to their practices (and that also comply with all HIPAA rules and regulations).  In working with any EHR vendors, practices may consider having language placed in vendor contracts to include a “meaningful use” standard to help insure compliance with the relevant standards.

Either way, it is prudent to stay informed of the final regulations that come out later this year.  There is no turning back the clock on the use of EHR – so you must either get with the program NOW, or risk getting further behind in the coming years.  Even if your practices’ record keeping has “always been done that way,” it’s time to move toward a reliable, certified EHR system while the government helps offset the capital investment needed to do so.