By: Mary Ann Ciccone
As part of ARRA, Medicare and Medicaid will provide reimbursement incentives to physicians and hospitals who become “meaningful users” of EMR. This effort will begin in 2011 and end by 2015 at which time all providers will be expected to utilize EMR. Changes will be implemented in stages and include data sharing, compliance with HIPPA and state laws, evidence based order sets, the engagement of patients and families, and care coordination. The final draft recommendations that will define meaningful use were published by the ONC for Health IT in December 2009. Eligible facilities and providers can incorporate these guidelines into projects currently in progress to meet the requirements.
The result of following the meaningful use guidelines for all stages will be improved and more efficient patient care through the use of disease prevention and reduction of medication errors, greater communication between providers, efficiency in meeting reporting mandates and claims submissions, and lower healthcare costs.
The recommendations for Stage 1 are listed below.
|
Criteria
|
Provider
|
Hospital
|
|
Use CPOE for all order types
|
x
|
x
|
|
Implement drug-drug, drug-allergy, drug-formulary checks
|
x
|
x
|
|
Maintain problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT
|
x
|
x
|
|
Generate and transmit permissible prescriptions electronically
|
x
|
n/a
|
|
Maintain active medication and medication allergy lists
|
x
|
x
|
|
Record demographics
|
x
|
x
|
|
Record and chart changes in vital signs
|
x
|
x
|
|
Record smoking status for patients 13 years old or older
|
x
|
x
|
|
Include lab test results into EHR
|
x
|
x
|
|
Generate lists of patients by specific conditions to use for quality improvement and report quality measures to CMS or the states
|
x
|
x
|
|
Send reminders to patients per patient preference for preventive/follow-up care
|
x
|
n/a
|
|
Implement 5 clinical decision support rules
|
x
|
x
|
|
Check insurance eligibility electronically from public and private payers and submit claims electronically
|
x
|
x
|
|
Provide patients with electronic copies of the following (per request):
- Discharge instructions and procedures
- Timely access to their health information
|
n/a
x
|
x
n/a
|
|
Provide clinical summaries for patients for each office visit
|
x
|
n/a
|
|
Ability to exchange key clinical information among providers of care and patient authorized entities electronically. Provide summary care record for each transition of care and referral
|
x
|
x
|
|
Perform medication reconciliation at relevant encounters and each transition of care
|
x
|
x
|
|
Ability to submit electronic data to immunization registries
|
x
|
x
|
|
Provide electronic submission of reportable lab results to public health agencies
|
n/a
|
x
|
|
Provide electronic syndromic surveillance data to public health agencies
|
x
|
x
|
|
Protect electronic health information created or maintained by the certified EHR technology
|
x
|
x
|
Source: HHS website for meaningful use.