Do you currently use an electronic health record (EHR) or are you in the process of implementing a new EHR? If the answer is yes, are you expecting your government incentive payment? If the answer is yes, you need to first stop and evaluate if you are a “Meaningful User”. It is not as simple as install the EHR and the incentive payments will come. In order to be eligible for the Medicare or Medicaid incentive payments that were designated by the American Recovery and Reinvestment Act of 2009 (ARRA), you must first prove that you are using the EHR in a meaningful way.
In December of 2009, The Center for Medicare and Medicaid Services (CMS) released the Interim Final Rule on Meaningful Use. During the time between December 2009 and July 2010, CMS accepted public comment and feedback on the proposed rule. On July 13, 2010 the Final Rule was released with some significant changes. The committees took the comments seriously and adjusted many of the requirements to allow for easier early adoption. However, there still exists some significant effort to be sure you will be considered a meaningful user.
The first step in this process remains unchanged: to have a “Certified EHR” in place. Not any EHR, but a certified EHR. This is very important for those who have had an EHR in place for the past few years. Has your vendor achieved the certified status? If so, have you upgraded to the version that is certified? If your EHR vendor has not committed to get their solution certified by 2011, it may be time to consider a different solution.
Once you have a certified EHR, you must tackle the hard part of this process. As things stand, there are 25 criteria for Eligible Professionals (EP). Originally, all 25 criteria were to be met in full. However, the Final Rule relaxed that requirement and broke the 25 into two separate groups, Core Criteria Set and Menu Criteria Set. Currently, there are 15 Core criteria which must be met. In addition, there are 10 Menu criteria and the EP must choose 5 of the 10 to meet. That makes a total of 20 criteria that providers need to meet in order to be considered a Meaningful User.
Meaningful Use will be rolled out in three separate stages. Stages 2 and 3 are expected to get stricter. The proposed Stage 2 criteria is expected to be released in late 2011 and will not go into effect until 2013. The timeline for Stage 3 is not yet determined. The proposed rule had a timeline for Stage 3 but the final rule repealed any timing definition.
What else changed between the proposed rule and final rule? Most of the criteria measures were relaxed in the final rule. In addition, two criteria were removed and two new criteria were added.
One important fact is the incentives and compliance with Meaningful Use is provider specific. A multiple provider practice can have providers who are not Meaningful Users or who choose not to be Meaningful Users. It is very important for each provider to understand the criteria and to do a self assessment.
Until recently, there was a great deal of hesitation to engage in any serious thought about Meaningful Use because it was not final and there were so many potential changes. Now that the rules on Meaningful Use and the ruling on EHR certification criteria are final, it is time to start taking a serious look at your current EHR situation and how you use it. It is likely that your practice will require some significant process changes to accommodate the new criteria defined in Meaningful Use.
If you would like more information on the Meaningful Use criteria or to get a copy of the Dean Dorton Ford Stage 1 – Meaningful Use Assessment for Eligible Professionals, please contact Jason Miller at jmiller@ddftech.com or (859) 425-7626
Jason D. Miller
Director, Technology Consulting
