The Department of Health and Human Services has recently come out with guidelines on the meaningful use of EMR. There are 3 stages of meaningful use.
The first stage involves “electronically capturing health information to track key clinical conditions and communicating that information for care coordination purposes; implementing clinical decision support tools to facilitate disease and medication management; and reporting clinical quality measures and public health information.” The second stage involves encouraging “the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.” Stage 3 involves focusing on promoting quality and operational improvements, focusing on decision support for priority conditions, providing access to comprehensive patient data and improving population health. At present only the guidelines for phase I have been specified. A detailed discussion of each of the guidelines for stage 1 can be found in this Software Advice article.
The federal government will provide subsidies for each of the years an eligible provider adopts EMR meaningfully as shown by the table below (courtesy Software Advice):
There are substantial rewards in being an early adopter of EMR. While the carrots are present up until 2015, the sticks kick in post 2015. Those practices that procrastinate will be penalized in Medicare and Medicaid payments:
- 2015 - 1%
- 2016 - 2%
- 2017 - 3%
- 2020 - 5% (maximum reduction)
Guidelines around the first stage of meaningful use are:
- Use Computerized Physician Order Entry
- Implement drug-drug, drug-allergy, drug-formulary checks.
- Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CTÂ®.
- Generate and transmit permissible prescriptions electronically (eRx).
- Maintain active medication list.
- Maintain active medication allergy list.
- Record the following demographics: preferred language, insurance type, gender, race and ethnicity, and date of birth.
- Record and chart changes in the following vital signs: height, weight and blood pressure and calculate and display body mass index (BMI) for ages 2 and over
- Record smoking status for patients 13 years old or older
- Incorporate clinical lab-test results into EHR as structured data.
- Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
- Report ambulatory quality measures to CMS
- Send reminders to patients per patient preference for preventive/follow-up care.
- Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules.
- Check insurance eligibility electronically from public and private payers.
- Submit claims electronically to public and private payers.
DeerWalk is building an EMR application for small and medium physician practices. Our EMR application will be bundled with services that make it easy for physician’s to adopt EMR and digitize their patients’ records. Physicians can run their practice just as seamlessly as they did before. Our EMR will comply with the meaningful use and certification criteria of HHS. Our series of EMR blogs are written by people who feel passionately about how EMR can make US Healthcare more efficient and more effective. If you are interested in our product, please contact us.