Editorial

Abstract

The American Recovery and Reinvestment Act of 2009 provided financial incentives to providers and hospitals to adopt, implement, and demonstrate meaningful use of certified electronic health records (EHRs). The criteria, objectives, and measures for EHR meaningful use are organized into three stages covering a five-year period. Stage 1, started in 2011, set the baseline for electronic data capture and sharing health information in a structured format. Stage 2 is building upon the first stage with a focus on data aggregation and quality improvement at the point of care. The final stage will focus on using data to affect outcomes. The Centers for Medicare and Medicaid Services' final rule, published in August, specifies stage 2 criteria for this EHR incentive program. The regulations were based on recommendations from the Department of Health and Human Services Health IT Policy Committee, which coordinates input from industry and providers. Beginning Oct. 1, 2013, eligible hospitals will be required to report clinical quality measures (CQMs) to qualify for incentive payments. Hospitals are required to report on 16 of 29 CQMs endorsed by the National Quality Forum, regardless of participation in stages 1 or 2. The CQMs chosen by hospitals must relate to at least three of six domains defined in the HHS National Quality Strategy (NQS). The clinical process and effectiveness domain includes the CQM Hearing Screening Prior to Hospital Discharge, a newborn hearing screening endorsed by NQF in August 2011. This measure was developed by the Centers for Disease Control and Prevention's Early Hearing Detection and Intervention (EHDI) program. The CDC, as the measure steward, will be responsible for maintaining and updating EHDI CQM electronic specifications. The stage 2 final rule for meaningful use outlines the process to submit CQM data electronically to reduce the burden of reporting. This rule requires that reporting EHDI CQM and other aggregate measures must be done using the Health Level Seven Category III Quality Reporting Data Architecture (QRDA), an XML format that humans and machines can read. This aggregate QRDA report will be generated and transmitted electronically by the hospital EHR via a CMS-designated transmission method. Beginning in 2015, hospitals that do not demonstrate meaningful use of EHR systems will be subject to a payment reduction for services provided, according to the EHR Incentive Program Final Rule. The final rule publication is available at http://bit.ly/FedRegRule. Read more about NQF's quality measure consensus process at: http://bit.ly/NQFprocess. Learn about CDC's EHDI program at http://bit.ly/CDCprogramEHDI. Click and Connect! Access the links in The Hearing Journal by reading this issue on our website or in our new iPad app, both available at thehearingjournal.com. Find us on Twitter at twitter.com/hearingjournal and Facebook at www.facebook.com/HearingJournal.