Commentary

Meaningful Use – the Details (Part I)


 

We’ve written before about meaningful use, the term the government has coined to refer to criteria that must be met to show that a physician not only has an electronic health record system, but is using that EHR in a meaningful way. In reporting meaningful use and meeting the defined criteria, physicians can qualify for government incentives that can be up to $44,000 under Medicare and up to $63,700 under Medicaid.

This general concept is now well appreciated in the medical community, but some of the common questions we have been asked are about the program details, what physicians need to do to achieve meaningful use, and how they go about showing that they have achieved the necessary criteria to qualify for the incentives.

Dr. Neil Skolnik and Dr. Chris Notte

We will spend the rest of this column addressing these details, and by so doing, we hope to relieve some anxiety about how to achieve meaningful use. This program was set up for physicians to be successful in attaining the incentives as they follow a systematic approach, work with their vendor, and leave themselves enough time both to see where they currently are and to improve the areas in which they are deficient.

The elements of meaningful use that must be achieved are divided into two areas: a set of 15 core objectives (all of which must be achieved), and a set of 10 additional “menu” measures (from which a practice can select the measures they will submit). The measures are described by their objectives and the ways each of those objectives are measured. We will list the core measures in this month’s column and the additional menu measures in next month’s column.

It is important to note that in order to count toward meeting meaningful use criteria, information in the indicated areas must be recorded as structured data. For example, a description of smoking status will not count toward meeting meaningful use criteria if it is documented as free text in the history of present illness (or in the social history), but it will count toward fulfilling the criteria if it is entered as structured data in the area of the EHR that records and tracks tobacco use.

This is a common source of frustration for many physicians, because it requires a change in workflow from what they may be used to, and documentation in a manner that may be new.

A review of these core measures listed in the table below shows that achieving them, for the most part, should be possible – as long as attention is paid to the manner in which the measures need to be recorded. A feedback system is in place to see how well the practice is doing at meeting the core measures.

Next month, we will review the meaningful use menu measures, as well as suggestions for getting help if needed and some practical aspects of how to report meaningful use criteria.

Reference

Eligible Professional Attestation Worksheet for the Medicare Electronic Health Record (EHR) Incentive Program.

Dr. Skolnik is associate director of the family medicine residency program at Abington (Pa.) Memorial Hospital and professor of family and community medicine at Temple University, Philadelphia. He is also editor in chief of Redi-Reference, a software company that creates medical handheld references. Dr. Notte is in private practice in Chalfont, Pa. They are partners in EHR Practice Consultants, helping practices move to EHR systems. Contact them at info@ehrpc.com.

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