Thursday, February 25, 2010

What is Meaningful Use?

$19.2 billion in Recovery Act funding has been designated to modernize the health care system by promoting and expanding the adoption of health information technology, but what is going to happen? Like it or not, all health professionals will be significantly impacted by the Health Information Technology for Economic and Clinical Health Act, or HITECH, and we will all have to change the way we work.

A carrot and stick approach has been taken with HITECH, with incentive payments for implementing electronic medical records (EMR) starting in 2011 averaging $44,000 per physician who achieves “meaningful use” of EMR’s, and reductions in patient payments from 2017 for those who don’t. It is not sufficient for EMR’s to be installed or available – they have to be in demonstrable routine “meaningful” use.

The Centers for Medicare and Medicaid Services has released a 555 page document that outlines the requirements for “meaningful use”. The proposal contains 25 measures for physicians and 23 measures for hospitals.

Let’s examine some of these.

At least 80% of all unique patients seen per provider must have demographics, an up-to-date problem list of current and active diagnoses and an active medication and allergy list recorded electronically, while clinical summaries must be provided to patients for at least 80% of office visits. Computerized Physician Order Entry must be used for at least 80% of all orders, the functionality for drug-drug, drug-allergy and drug-formulary checks must be implemented and at least 75% of all prescriptions written per provider are to be transmitted electronically.
The other measures, many of which require interoperability with other data systems for public health purposes, are detailed on the HITECH website.

It is evident that achieving “meaningful use” will significantly change the way much of American medicine is practiced. Dr David Blumenthal, National Coordinator for Health IT, has agreed that the proposed rules aim to “stretch” the health care community, but not “break” it. This is an exciting opportunity to radically improve patient care, underpinned by informatics expertise, and is one that we should welcome and support.

A video version of this post is available on and at www.ucdmc.ucdavis/informatics