A Useful Meaning for Meaningful Use?

August 5, 2010 at 4:02 pm Leave a comment

Image via HealthITBlog

While the march towards universal EHR adoption continues, some resistance to implementation has emerged, including from inside the medical community. Some of the hesitation is based on safety issues and privacy concerns – people worry that the personal content of health documents could be viewed by anyone or that opportunistic hackers could easily gain access to our most intimate details. I’ve written about this argument before and concluded that, while I agree it’s important to proceed cautiously and intelligently, we must proceed nonetheless.

One of the biggest impediments to electronic health record adoption has been the lack of concrete definition of “meaningful use.” But let’s not get too far ahead of ourselves. In order to receive government funding/aid in the form of incentive payments from Medicare and Medicaid, facilities have to demonstrate that their electronic health record serves or provides “meaningful use” to the practice and physicians. The definition for meaningful use has been murky and vague; a subjective and fleeting characterization that made many physicians and health facilities reluctant to commit to any electronic solutions for fear of not being reimbursed or not qualifying as “meaningful use.” Luckily, this issue has been resolved – mostly – thanks to the definition put forth by the Office of Health and Human Services. So what is the definition and what does this mean for health information technology?

The definition is a multi-tiered approach that provides specific outlines detailing how health facilities/practices have to use their electronic solutions. In a surprising display of understanding, many of the aspects of “meaningful use” allows for only a percentage of interactions to be electronically driven. Understanding that we’re still in a time of transition, meaningful use of an EHR is achieved by accomplishing electronically a portion of what was previously done on paper. It appears the reason for this is to encourage facilities to use electronic solutions for most of their processes, while remaining pragmatic about the ability to roll out such system-wide changes across an entire organization.

Here’s Health and Human Services Secretary Kathleen Sebelius rolling out the new standards and definition for meaningful use and qualifying EHRs:

Meaningful use has been defined. Practices, physicians and facilities know what to look for when they adopt an electronic solution in order to receive the Medicare/Medicaid reimbursements and incentives. Now what? Now that administrators – those most interested in finance, compliance and health information management – know what they need to be doing to secure the data and what will financially help their facility the most comes the hard part of weeding through all of the options that are out there. Not only will the solution chosen for the hospital/practice/ASC have to meet these government requirements (including HIPAA compliance), but they can’t be intrusive to the user or disrupt the current workflows of these facilities.

There are many companies that have been developing various electronic solutions for health facilities. Some are more focused on hardware, scopes, implants, etc. Others are more focused on reading vital signs and pulling data from multiple sources to create one unified health record. Still others, like mTuitive OpNote, only focuses on one aspect of the entire treatment (in our case, postoperative reporting). Most of these products and programs were created before there was anything approaching a definition of meaningful use. How will each of these EHRs and health IT solutions change to accommodate this definition? What changes will have to be made going forward in developing each part of these electronic approaches? These questions remain to be answered and will only play out as time goes on and more products come on to the marketplace to fill the need of medical personnel.


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