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The Latest on Meaningful Use

The draft matrix for the 2011, 2013 and 2015 Meaningful Use requirements has been released.  What does it mean for the EHR selection process?

Click Here and scroll down to download the draft Meaningful Use Matrix released on June 15, 2009 by  the National Health IT policy committee.

These are not the final Meaningful Use criteria.  Final criteria are expected in early 2010.  The draft criteria inlcude 22 Objectives for 2011 and 24 Measures for those objectives.  Objectives and corresponding Measures are also outlined for 2013 and 2015.

While the criteria are not final, there are some themes to the types of objectives and measures that will likely remain in the final version:

  • A combination of requirements that your EHR must meet as well as those you must meet (that may also require use of an EHR).  For example, one of the 2011 Objectives is “Maintain an active medication list”.  Your EHR should allow you to easily do this, however, the provider/staff will still need to import/add a patient’s existing medications and verify this with the patient.
  • Reporting adherence to established protocols for high cost chronic diseases, such as diabetes.  For example, the draft 2011 Measures include reporting the percentage of diabetics with A1c under control.
  • Patient communication objectives.  For example, the 2011 Objectives include providing clinical summaries for patients and access to patient-specific educational resources.
  • Submitting key patient data to public health agencies.  For example, the 2011 Objectives include submitting data to immunization registries and reportable lab results to public health agencies.

What will change in the final version?

No one knows for sure.  However, early feedback on the criteria indicates that some vendors and providers feel that the initial 2011 Measures are too voluminous.  There has also been feedback that some of the reporting/data submission requirements should be deferred until there is standardization of the data elements reported.

What does this mean to EHR selection?

While you could suspend your EHR selection until the criteria are finalized, that will reduce your window to select and implement an EHR in time to receive ARRA funding in 2011.  Even if you base your EHR selection on a product’s ability to support the current draft Meaningful Use criteria, how do you know your EHR will meet the final Meaningful Use criteria for 2011 and future years?

My suggestion:

The vast majority of our providers implemented EHR before the ARRA/Stimulus funding was a consideration.   They purchased an EHR system to solve one or more problems in their practice and/or improve their financial bottom line.  We consistently hear comments like “I wish I had implemented an EHR sooner”.

So, I suggest treating the ARRA/Stimulus funds like a tie-breaker or added reason for implementing EHR but starting first with your current problems and needs.  If EHR will solve some of your practice’s problems and/or improve your bottom line, start your fact finding and EHR selection process now.

Look first to CCHIT certified systems.  2008 is the latest available certification year.  The CCHIT certification criteria include many of those included in the draft Meaningful Use Matrix.  Furthermore, CCHIT certification shows that a vendor has the resources and desire to meet standards.

Next, limit your final vendor list to those that include a committment to ARRA/Stimulus certification in their contract with you.  You need to know that your vendor is committed to ensuring their product will enable you to receive funding not only in 2011 but also in future years.

Does this mean you will be “stuck” with one of those $50,000+ per Provider EHR systems?

While much has been written about the high cost of EHR systems, gone are the days when it cost $50,000 or more per provider to implement and maintain a strong EHR system.  There are more products to choose from now, including hosted or true Internet-based systems, at much lower pricing (and total cost of ownership) than were available several years ago.  After considering ease of use, CCHIT, customer service, functionality and other criteria important to your selection, you should still have several vendors to choose from that are within your budget.

C Huddle, VP, Market Development