The meaningful use of electronic health records refers to the use of EHRs in ways that healthcare providers can measure qualitatively and quantitatively. The United States government has enacted legislation that will roll out requirements for the meaningful of EHRs in three stages, from 2011 to 2016. Stage 2 is scheduled to become effective in the near future, and will impose additional requirements for healthcare providers who wish to qualify as meaningful users.
Overview
The Health Information Technology for Economic and Clinical Health(HITECH) Act of 2009 describes the intended benefits of this act. They include an improvement in the general health of the population in the United States and in increase the security and privacy of health information for patients. The HITECH Act will also engage patients in their healthcare and reduce disparities in healthcare among patients of different economic means. It will also improve the coordination of patient care between healthcare providers.
The Obama Administration plans to use financial incentives to promote the use of EHRs. These include incentives for software developers who obtain certification for EHR software, which will ensure that this software meets specified quality standards. The incentives will also enforce open standards for EHR software to ensure that software vendors and users have the same goals.
Schedule
The U.S. Department of Health and Human Services provides specific criteria for meaningful use in each of the three stages. Stage 1 was implemented from 2011 to 2012 and deals with data capture and sharing. Stage 2 will be implemented in 2014 and will deal with advanced clinical processes. Stage 3 is scheduled to be implemented in 2016 and will address improved outcomes for patients.
Stage 2 will require health information exchange to become more rigorous. It will also increase the requirements for prescribing medication through electronic means, commonly known as e-prescribing. Stage 2 will incorporate the use of lab results into the criteria for meaningful use. The transmission of patient care summaries will also be addressed in Stage 2, as will additional data that is controlled by patients.
Criteria
The Centers for Medicare & Medicaid Services (CMS) describes the objectives of meaningful use for each stage, which consists of core objectives and menu objectives. Stage 2 introduces a new set of objectives, most of which are menu objectives. Many of these objectives provide exceptions that allow healthcare providers to qualify as meaningful users without meeting objectives that fall outside the scope of the provider’s clinical practice.
Eligible healthcare professionals who wish to qualify as meaningful users under Stage 2 must meet all 17 of their core objectives and three out of six menu objectives for a total of 20 objectives. Eligible hospitals are required to meet all 16 of their core objectives and three out of six menu objectives for a total of 19 objectives.
Some objectives are common to both healthcare professionals and hospitals, while others are different. For example, both groups must use computerized provider order entry to order laboratory test, medication, and radiology tests. Both groups must also record demographic information for a patient such as gender, race, ethnicity, date of birth and preferred language. Additional requirements for both groups include recording the patient’s vital signs such as height, weight body mass index. They must also record the blood pressure for patients older than three years and smoking status of patients older than 13 years.
Objectives that are different between hospitals and healthcare professionals include the requirement of hospitals to provide patients the lemon aerie cause of death. Hospitals must also perform medical reconciliation when transferring a patient between settings under certain circumstances.