What Will Meaningful Use Mean to Your Practice?

Abstract

When it comes to the use of electronic medical records (EMRs) or electronic health records (EHRs), many physicians have already witnessed benefits for their practice, such as patient care coordination, work efficiencies, record keeping, and decreased paperwork [1]. Many large practices and health systems use EHRs to track use of services, patient outcomes, and physician practice patterns. This information is and will be critical for providers interested in participating in Medical Homes projects or Accountable Care Organizations. Although the need for EHRs may be obvious, there are many challenges for all practices to obtain and to deliver interoperable systems. Many hospital systems and individual physician practices customize their data collection and reporting; therefore, a major challenge is how to make all of the separate systems “meaningful” to each other. The American Recovery and Reinvestment Act of 2009 (ARRA, or Recovery Act) introduced many health care reform issues, including the Health Information Technology for Economic and Clinical Health (HITECH) Act. Previously, there had been no uniform method of adoption or requirements mandated for EHRs. To speed the progression of adoption and use of EHRs, the HITECH Act included previsions for more than $20 billion in incentive payments to hospitals and eligible professionals (EPs) who demonstrate meaningful use of certified EHRs [2,3]. The ARRA specifies its 3 main components of meaningful use: 1) The use of a certified EHR in a meaningful manner, such as e-prescribing; 2) the use of certified EHR technology for electronic exchange of health information to improve the quality of health care; and 3) the use of certified EHR technology to submit clinical quality and other measures [4]. The federal government has proposed a 3-stage process to promote “meaningful use” for HRs. Stage 1 final regulations outlining eligibility for incentive payments were published in he Federal Register in July 2010 [5]. Eligible professionals now have the potential to receive p to a total of $44,000 during the next 5 years under the Medicare EHR incentive program r up to $63,750 during the next 6 years through the Medicaid program (Table 1) [6]. nitially, incentives are being provided; however, it is important to note that by the end of 014, Medicare EPs who do not successfully demonstrate meaningful use will receive egative adjustments to their Medicare payments. This negative adjustment is scheduled to e 99% of their professional payments (1% decrease) for 2015 with subsequent annual djustments to follow [5]. These incentive programs are based on meeting the Centers for Medicare and Medicaid ervices (CMS) requirements and the EP’s eligibility to participate in the Medicare or edicaid programs. The challenges for physicians, whether in a solo practice, multispecialty roups, large practice, employed by a hospital, or other, will be to determine eligibility, omputer requirements, data-entry requirements, meeting time frames, and verification of esults. Some of the specific issues for Stage 1 are reviewed in this article because they resent some practice management challenges that all providers will face in the future. The cope of this article will address Medicare EP requirements and not those for hospitals.