Med3000 Blog

Now that physicians are becoming aware of the Meaningful Use  (MU) criteria associated with the HiTech stimulus package, a lot of questions are surfacing. Physicians are evaluating whether or not the reward will justify the work required to achieve MU. Across the country, practices are evaluating what the anticipated practice costs will be to both choose and implement an EHR under the regulations. Complying with the criteria for MU will require physicians to change their practice workflow. Some physicians may have to change their documentation process significantly to comply with the proposed regulations. I have had many conversations with high-volume/high-revenue practices that are simply turning their back on stimulus funds due to the fact they feel they will actually lose money in trying to comply. If the maximum reward you can receive from the Federal government is $18,000 the first year, and your practice net revenue is $500,000, the stimulus dollars start to become insignificant in the overall practice. This is especially true if the practice’s productivity is negatively impacted.

Many physicians think that MU criteria are actually good for the practice of medicine. However, they also feel that the products are not robust enough to actually allow these workflow changes without severely impacting their practice.

All products are not created equal.  While some may not be robust, InteGreat EHR is prepared to meet MU with an intuitive design that allows adaption to your workflow.

What are your practice’s concerns about MU?

Do you think by requiring high MU standards physicians will embrace EHR technology or will recheck the incentive and proceed with the status quo?

The long-awaited definition of Meaningful Use of an EHR to qualify for the ARRA Stimulus Incentives was recently approved by the Office of the National Coordinator and the recommendations were sent to the Center for Medicare & Medicaid Services (CMS). 

• “Meaningful use” means exactly that. Physicians will have to fully implement and use an EHR and report that usage to receive Federal stimulus funds.
• The current “meaningful use” reports that have been drafted include diagnoses that must be documented within the EHR by July of the reporting year.
• The determination of the reporting year has yet to be established.
• Federal regulations regarding how stimulus funds will be delivered based on “meaningful use” will not be finalized until early second quarter 2010.
• Time is of the essence; delaying selection of a certified EHR into 2010 may result in loss of stimulus monies for the first reporting year.
• InteGreat is CCHIT 2008 premarket conditionally certified.
• There will be multiple certification bodies created. This means that CCHIT certification will not carry as much weight in the marketplace as it has in the past.
• Stark compliance will most likely be based on the new certification path as determined by ONCHIT.

The 2011 recommendations include:

• Use CPOE for all orders
• Implement drug-drug, drug-allergy, drug-formulary checks
• Maintain an up-­to-date problem list of current and active diagnoses based on ICD-9 or SNOMED
• Generate and transmit permissible prescriptions electronically (eRx)
• Maintain active medication list
  Maintain active medication allergy list
  Record demographics:
  • preferred language
  • insurance type
  • gender
  • race
  • ethnicity
• Record advance directives
• Record vital signs
• Record smoking status
• Incorporate lab results as structured data
• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, and outreach
• Report ambulatory quality measures to CMS
• Send reminders to patients per the patient’s preference for preventive and follow-up care
• Implement one clinical decision rule relevant to specialty or high clinical priority
• Document a progress note for each encounter
• Check insurance eligibility electronically from public and private payers, where possible
• Submit claims electronically to public and private carriers
• Provide patients with an electronic copy of their health information (including lab results, problem list, medication lists, allergies) upon request
• Provide access to patient-specific education resources
• Provide clinical summaries for patients for each encounter
• Click here to view a full copy of the definition approved by the Office of the National Coordinator.

While final rules may not be released until Spring, the InteGreat EHR R&D team and executives are closely monitoring the recommendations and preparing to implement them so that our clients will be ready to collect incentive payment in the time table outlined.