31 hours ago · CMS FINALIZES DEFINITION OF MEANINGFUL USE OF CERTIFIED ELECTRONIC HEALTH RECORDS (EHR) TECHNOLOGY The Centers for Medicare & Medicaid Services (CMS) today announced a final rule to … >> Go To The Portal
To improve patient care, EHRs and other health technology must work well for the people who use them. Unfortunately, the swift implementation of EHR technology compelled physicians to purchase tools not yet optimized for patients or doctors.
By using certified EHR technology to report information on clinical quality measures electronically to a health information network, a State, CMS, or a registry, the burden on providers that are gathering the data and transmitting them will be greatly reduced.
On the plus side, the EHR adoption rate by hospitals in the United States is nearly perfect, with 96% having a federally tested and certified EHR program—a ninefold increase since 2008.4In addition, almost 80% of office-based physicians have a certified EHR system in place.5
In recent months, the federal government has enacted regulations and programs in order to accelerate the implementation of EHRs by healthcare providers and healthcare organizations.
The American Recovery and Reinvestment Act of 2009The American Recovery and Reinvestment Act of 2009 (ARRA) authorized incentive payments to eligible hospitals and physicians that are "meaningful users" of electronic health records (EHRs).
Meaningful Use (MU) is the utilization of a certified EHR system to improve quality, safety, efficiency, and reduce health disparities, improve care coordination, improve population and public health, engage patients and their families in their own health care, and ensuring that patient privacy and security is ...
If CMS determined that a successful demonstration of meaningful use applied, the parties were then considered eligible for federal funds. Because the meaningful use program was technically voluntary, meaningful use criteria were considered guidelines, not regulations.
To demonstrate meaningful use, EHRs should be:Improving quality, safety, efficiency and reducing health disparities.Engaging patients and families in their health.Improving care coordination.Improving population and public health.Ensuring adequate privacy and security protection for personal health information.
Why is Meaningful Use important? The aim of the Meaningful Use incentive program is to improve the quality, efficiency, and coordination of patient care by leveraging certified EHR technologies securely and efficiently. Patient privacy and provider efficiency are at the heart of the Meaningful Use incentive program.
As EPs and health care organizations reach Meaningful Use of EHRs that ultimately enable the exchange of critical information across a health care system, the health care system will realize improvements in individual and population health outcomes, increased transparency and efficiency, and improved ability to study ...
MIPS Builds on Meaningful Use Improve quality, safety, efficiency, and reduce health disparities. Engage patients and family. Improve care coordination, and population and public health. Maintain privacy and security of patient health information.
This question comes up a lot. We've got a simple answer: No, it's not – but the name is. The EHR Incentive Program, commonly known as Meaningful Use (MU), has been considered over or has “died” many times, but it is still around.
To fulfill the requirements for Meaningful Use, eligible professionals must successfully complete the 3 main components of the program: 1) use certified EHR, 2) meet core and menu set objectives, and 3) report clinical quality measures.
The HITECH Act outlines two main goals 1) to make electronic health records interoperable by establishing standards and 2) to develop a national network for providers to share electronic data. These goals support EHR use. The HITECH Act works to create standards for EHR systems and the protection of health data.
In the simplest terms though, meaningful use means taking steps to boost patient care with an EHR by improving the communications between patient and provider, provider and insurance, and provider to provider.
Three organization elements essential for successful health information systems implementation are: technology, policies and procedures, and culture.
Certified EHR technology used in a meaningful way is one piece of a broader Health Information Technology infrastructure needed to reform the health care system and improve health care quality, efficiency, and patient safety. The Office of the National Coordinator for Health Information Technology ...
The Medicare EHR incentive program will provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHR technology. The Medicaid EHR incentive program will provide incentive payments to eligible professionals and hospitals for efforts to adopt, ...
The Medicaid EHR incentive program will provide incentive payments to eligible professionals and hospitals for efforts to adopt, implement, upgrade or meaningfully use certified EHR technology. This fact sheet summarizes CMS’ final definition of meaningful use.
If an exclusion applies to an EP or eligible hospital, then such professional or hospital does not have to meet that objective/measure in order to be determined a meaningful EHR user.
The meaningful use criteria is the culmination of an intensive process that involved input from several Federal Advisory Committees (the National Center for Vital Health Statistics, the HIT Policy Committee, and the HIT Standards Committee) and a notice of proposed rulemaking (NPRM) published on January 13, 2010.
The HHS Office of the Inspector General (OIG) and CMS published companion rules that allow physicians to accept donations of almost free EHR technology (must pay at least 15% of the cost of the technology) from certain health care entities without violating Stark and anti-kickback rules.
Physicians must use certified electronic health records technology (CEHRT) and demonstrate meaningful use through an attestation process at the end of each MU reporting period to avoid the penalty. Avoiding the 2017 Meaningful Use penalty.
However, EHR design is also heavily influenced by the federal requirements for MU and certification. While there are federal requirements on EHR usability, the design priority of EHR vendors continues to be meeting MU objectives, not the needs of physicians and patients.
Physicians can either purchase a comprehensive certified package from a single vendor or certified components from different vendors. Physicians should ask their vendor about certification plans if they are unclear whether their EHR technology or module (s) are certified for use in the incentive program.
It is important to note that a health IT system is typically larger than just EHR. The first step in protecting a practice and patients’ health information from cyber attacks is evaluating a system’s security. The rules for a risk analysis are not prescriptive; a number of different tactics can achieve compliance.
CMS has an informal appeals process for those denied an EHR incentive payment, determined to be ineligible for the program, or given an unfavorable audit decision. Physicians looking to appeal an adverse decision should contact their state Medicaid Agency for information about filing an appeal.
Electronic health records (EHRs) have emerged as a major topic in health care and are central to the federal government’s strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices.
Electronic health record (EHR) systems are now a major topic in health care. Use of EHRs in physician practices and in healthcare organizations directly impacts the communication and management of laboratory information in patient care, particularly reporting of laboratory results and test order management.
The American Recovery and Reinvestment Act of 2009 (ARRA), enacted in February 2009, included several provisions that in aggregate comprise the Health Information Technology Economic and Clinical Health Act, or “HITECH Act.” The HITECH Act includes a number of provisions aimed at improving healthcare quality, safety, and efficiency through promotion of health information technology (HIT), notably EHRs, and through greater electronic exchange of health information.
The EHR incentive program establishes the criteria, reporting requirements, incentive payments, and (future) penalties for eligible professionals and hospitals related to achieving the meaningful use of EHRs. Eligible professionals and eligible hospitals are those that participate in the Medicare or Medicaid programs.
The CMS Final Rule on the EHR incentive program lays out the requirements for eligible professionals and eligible hospitals to meet the definition of meaningful use of certified EHR technology.
In July 2010, the Department of Health and Human Services and the Office of the National Coordinator for Health Information Technology (ONC) published the Final Rule: Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology (45 CFR Part 170).
The HITECH Act and the CMS EHR incentive/penalty programs aim to increase the use of EHRs by health care providers. Greater implementation of EHRs has important clinical, operational, and business implications for laboratories, particularly those that serve physician practices.
EHRs can facilitate the collection, storage, and sharing of comprehensive real-time information for health care providers to make informed decisions with their patients. EHR data can be created, managed, and accessed by authorized providers and staff across health care organizations. Furthermore, EHRs can integrate information from current and past health care providers and emergency facilities, as well as assemble clinical information from school and workplace clinics, pharmacies, laboratories, patient-generated health data, and medical imaging facilities. Evidence of EHR usage’s benefits continue to grow,1 and can include:
Health care providers not eligible for the EHR Incentive Programs, such as long-term care, post-acute care, and behavioral health providers, have a frequent need to exchange health information on behalf of their patients, who are among the most vulnerable and whose care is most costly.16 Advancing the adoption of certified EHR technology solutions to these providers will support the realization of the goals associated with implementing a nationwide health IT infrastructure and new models of care delivery and coordination.
Public health agencies collect health information to detect, track, and manage disease outbreaks. Local and state public health departments rely on information from health care providers. Traditionally, health care providers reported this information by paper, phone, and fax. Health IT tools can provide a faster and more accurate way of moving critical information from providers to health departments. These tools can also help public health departments conduct medical product safety surveillance, analyze population health trends, and educate and promote healthy choices for populations. The EHR Incentive Programs’ public health reporting requirements are spurring development of public health infrastructure to receive structured data from EHRs, increasing partnerships between health information organizations and public health, and fostering the development of public health reporting standards.61
Incremental steps to accelerate health information exchange will initially stem from Affordable Care Act (ACA) delivery system reform programs and Medicare payment regulations. HHS will consider ways in which the adoption and use of certified health IT products can be aligned with and encouraged by Medicare and Medicaid payment policy and other HHS programs funding health care delivery so that care delivery transformation and interoperability evolve in tandem.58 The following are efforts currently in place to reduce regulatory burdens and business barriers that prevent data flow.
The REC program supports EHR adoption and meaningful use among providers that historically have lower rates of EHR adoption, such as small practices, community health centers, and rural and public hospitals.
Telehealth technology expands health care delivery and offers important opportunities to improve care coordination in communities by linking health care providers with specialists and other experts not available locally, thereby increasing access and health care quality. The Telehealth Network Grant Program, a key HRSA program focused on expanding the reach of telehealth, funds projects demonstrating the use of telehealth networks to improve health care services for medically underserved populations in rural and frontier communities. This program seeks to help communities build the human, technical, and financial capacity to develop sustainable telehealth programs and networks. As of 2011, grantees provided a total number of 151 categories of clinical services, across 1,155 sites in underserved rural communities for 1,306 sites and services. In all, 310 communities had access to pediatric services and 304 communities had access to adult mental health services for which they otherwise would not have had access.
Under the HITECH Act, ONC, in consultation with the National Institute of Standards and Technology (NIST), recognizes and administers the ONC Health IT Certification Program (Health IT Certification Program) for the voluntary certification of health IT as being in compliance with applicable certification criteria that has been adopted under HITECH. Such program includes, as appropriate, the testing of health IT. Through rulemaking, the Secretary adopts the technical standards and criteria for certified EHR technology, with input from two Federal Advisory Committees and recommendations from the National Coordinator for Health Information Technology (National Coordinator). Health IT vendors then voluntarily submit their health IT products to be certified and tested under the Health IT Certification Program. In order to receive incentive payments under the EHR Incentive Programs, eligible professionals and hospitals must adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in ways defined by CMS. As of April 2014, there were 1,136 certified products.
As the nation’s largest healthcare payer, CMS operationalized the Medicare and Medicaid EHR Incentive Program by creating program policies and supporting systems necessary for its implementation. Through the EHR Incentive Programs, CMS developed program requirements through notice and comment rulemaking, which include the Meaningful Use objectives. These are measures and thresholds that eligible professionals, eligible hospitals, and CAHs must meet in order to receive an incentive payment. CMS also created the necessary program infrastructure in order to successfully implement the EHR Incentive Programs in accordance with existing payment policies, program eligibility criteria, as well as creating the interface with external systems. Below is an overview of the CMS efforts to increase adoption of health information technology and health information exchange.
A recent national survey of community-based behavioral health care providers found that approximately 65 percent use an EHR at one or more of their sites; one-fifth (21 percent) indicate they use an EHR across their sites, and 35 percent use a combination of paper/electronic across their sites.18 A national survey of long-term facilities (which includes residential care communities, adult day service centers, home health agencies, nursing homes and hospices) was conducted in 2012 though results are not yet available.19 Older, national surveys conducted across various types of facilities show variation in EHR adoption rates by setting. A 2010 national survey of residential care facilities found that 17 percent used any EHR, 3 percent had a basic EHR system and that more than half (55 percent) of these facilities had one or more of six electronic capabilities associated with a basic EHR. 20 Approximately 4 in 10 nursing homes (43 percent) had adopted any EHR and 2 in 10 had a basic EHR in 2004; among home and hospice care providers, 41 percent had adopted any EHR, and 10 percent had a basic EHR system in 2007.21 A 2011 survey of long-term acute care hospitals and rehabilitation hospitals show EHR adoption rates are lower than acute care settings. 22
SOURCE: ONC Customer Relationship Management (CRM) Database, maintained by the Office of Provider Adoption and Support (OPAS) at ONC , a national CAH database maintained by The Flex Monitoring Team, and the Small Hospital Improvement Program (SHIP) maintained by Health Resources and Services Administration (HRSA). Data as of February 18, 2013.
The top barriers to EHR adoption reported by office-based physicians include the cost of purchasing an EHR system and concerns regarding loss of productivity. At least 4 in 10 physicians who have yet to adopt EHRs also express concerns regarding EHR maintenance costs, selecting an EHR that meets their practice’s needs, adequacy of technical support, and practice resistance. 12 Key HITECH programs address many of these barriers, including the EHR Incentive Programs that offer financial incentives that support adoption and Meaningful Use of certified EHR technology and the REC Program that helps providers adopt and make Meaningful Use of EHRs. In order to address potential barriers to adoption related to privacy and security of electronic health information, the Office of the Chief Privacy Officer in ONC has developed a flexible, iterative process for assessing, prioritizing, and implementing privacy- and security-related initiatives.
eligibility and program policies are determined by CMCS in coordination with each state. CMCS plays a leadership role in the coordination within and among states to support the implementation of EHRs, and coordinates with state Medicaid program expansion and health marketplace efforts. Centers for Clinical Quality and Standards (CCSQ): In order to reduce provider burden with regards to reporting, CMS has worked with partners and representatives from industry to identify and finalize a set of unified quality measures that eligible health care providers could report to satisfy some of the various requirements of multiple programs in addition to meeting EHR Incentive Programs clinical quality measures requirements, including the Physician Quality Reporting System. CCSQ also administers a number of quality reporting programs, including the eRx Incentive Program, which also encourages provider to electronically prescribe. CCSQ is working to implement a unified set of electronic clinical quality measures (eCQMs) and electronic reporting requirements in order to permit broad scale electronic reporting of quality data across CMS programs.
The CMS Medicare and Medicaid EHR Incentive Programs provide financial incentives for the adoption and Meaningful Use of certified EHR technology to improve patient care. CMS established the EHR Incentive Programs through notice and comment rulemaking and created the necessary infrastructure to implement the program in accordance with existing payment policies and program eligibility criteria. CMS regulations spell out the objectives for the Meaningful Use requirements that eligible professionals, eligible hospitals, and CAHs must meet in order to receive an incentive payment.11 In addition to the incentives, eligible professionals, eligible hospitals, and CAHs that fail to demonstrate Meaningful Use of certified EHR technology will be subject to payment adjustments under Medicare beginning in 2015.
Because health IT is an integral component to health care reform, ONC believes that the RECs are uniquely equipped to support providers’ efforts use health IT to transform their delivery of care. This serves as a natural extension of their work to get providers to meaningfully use EHRs. Specifically, RECs are well positioned to continue to assist providers with the next stages of Meaningful Use (e.g., Stages 2 and 3) and further develop and implement other core competencies such as privacy and security assessments, and electronic health information exchange..