Lumetra Healthcare Solutions

While a final definition won’t be settled by the Office of the National Coordinator of Health Information Technology (ONCHIT) until later this year, ‘Meaningful Use’ refers to the criteria to be approved from the American Recovery and Reinvestment Act (ARRA) of 2009 to describe EHR system capabilities required of providers so they are able to qualify for Medicaid and Medicare incentive payments, as a result of the adoption of EHR systems. The Health Information Technology for Economic and Clinical Health Act (HITECH), a component of the American Recovery and Reinvestment Act of 2009, provides roughly $36 billion in expenditures for health information technology infrastructure and incentive payments to physician practices adopting electronic health records (EHRs), chronic disease management systems, and other technologies. The payments will commence in 2011 and will be paid over a five-year period for physician practices that can show “Meaningful Use” of an EHR system.

The charge of defining Meaningful Use for Electronic Health Records (EHRs) has captured and dominated many health information technology discussions lately. With a focus on making recommendations on the concept for 2011, 2013, and 2015, a Meaningful Use (HIT Policy) committee has been tasked with considering major barriers for systems adoption and how to remove those barriers and create specific requirements that facilitate improvements in healthcare quality. Information technology provides an underpinning for access to data to help build those improvements. The initial draft of Meaningful Use criteria has these intents:

1. Improve quality, safety, and efficiency while reducing health disparities;
2. Engage patients and their families;
3. Improve care coordination;
4. Improve population and public health;
5. Ensure adequate privacy and security protections for personal health information.

By meeting this criterion, healthcare reform goals, as noted below, become attainable:

• Impacting costs of healthcare through reductions in errors, formulary adherence, and duplication of testing.
• Creating the roadways for state and national information infrastructures.
• Assistance in reducing admissions.
• Providing the ability for quality reporting linked to incentive programs.
• Creating the ability to consider improvements in preventive care.

In an attempt to balance the need for acceleration in healthcare reform and outcomes improvements with considerations of the challenges associated with in the practice and capabilities of current healthcare IT systems and the time needed to implement, Meaningful Use has been staged to initially consider the following:

1. The capture and sharing of relevant care information, including e-Prescribing, basic health information exchange, CPOE (computerized physician order entry) for all order types, implementation of standards for data, and automated quality reporting on key disease states.
2. Leveraging decision support tools to advance care, including chronic disease management, evidence-based order sets, disease registry reporting, automation that assists with family involvement in patient engagement, and coordination of care with medication reconciliation, and prescription history and refill information.
3. Using automation to help improve outcomes will include integration of medical devices, Personal Health Record (PHR) access, and real time access to tools that aid patients in self-management.

However, there is a cost to this in both technology and effort. While incentives are a component of the process, the upfront costs for primary care providers along with rural physicians and hospitals may be great. To capitalize on the incentives, providers need to act now by pursuing basic steps in the consideration of technology as a component of their practice. Lumetra’s Health Information Technology division, Illumisys, is a leader in EHR implementation and provides a proven roadmap to EHR success, including:

• Practice assessment and workflow analysis to help you understand needs and establish goals for your practice.
• System selection services to give you peace of mind that your vendor is the ‘right choice.’
• Implementation assistance to ensure your business and clinical processes are not compromised by the inclusion technology.
• Project management to help with change management barriers and communications with vendors and staff throughout implementation.
• System optimization for those who have systems but need help with getting a full return of investment on the product.

For more information on how Meaningful Use and the HITECH-related incentive programs affect your practice, e-mail John Weir at jweir@lumetrasolutions.com, or call him at (415) 677-2083.