Meaningful Use 101: A Refresher Course for some, Enlightening for others

[Anita Karcz]

Given all its challenges and complexities, even the most educated and experienced among us can use a little extra help when it comes to MU. For the uninitiated and for those involved in the program who occasionally wake up at night with their head spinning, here’s a useful refresher course in the basics of Meaningful Use.

Unquestionably, EHRs and the IT systems that create them are the way of the future. These computerized patient records provide numerous benefits over the hardcopy healthcare documents stored in bulging notebooks and folders  at individual medical facilities. But the switch to EHRs requires an extensive investment of time, effort and capital on the part of healthcare providers and hospitals. The program popularly known as Meaningful Use was created to hasten the adoption of EHR systems with various incentives.

MU dates back to 2009 when the Health Information Technology for Economic and Clinical Health (HITECH) Act enabled the Department of Health & Human Services (HHS) to implement initiatives to improve quality-of-care through the promotion of healthcare IT systems, including EHRs. To achieve this,  the HHS Center for Medicare & Medicaid (CMS) introduced the Medicare & Medicaid EHR Incentive Programs, MU being one of those programs.

The programs provides financial incentives to eligible healthcare providers, hospitals and critical access hospitals (CAHs) that implement government certified EHRs and use them  in a ways that help improve patient care, exchange information with other providers and facilities and track quality measures. 

To qualify for incentives, providers and hospitals must meet specific, complex CMS-determined criteria demonstrating that their technology is being used meaningfully to achieve those goals. EHR users are then required to formally attest on Meaningful Use criteria to achieve payments.  

The MU program  began in Fiscal Year 2011 with the first hospital participants starting to collect data in October of 2010. It is to be implemented in three stages with increasingly demanding  requirements as participants progress through the program. All providers start by meeting the Stage 1 requirements for a 90-day period in their initial year of participation and for a full year in their second year (except for those hospitals first attesting in 2013 that only have to report on 90 days worth of data in 2014). 

After successfully passing through Stage 1, providers then must meet Stage 2 requirements for two complete years (except for 2014 where the attestation period is 90 days). After Stage 2, all hospitals will move on to Stage 3, which will require two years in each stage after that. Currently CMS has mapped out requirements through Stage 3. However, it has published that they retain the ability to add additional stages to the program at a later date.

The overall goals of Stage 1 are to demonstrate appropriate digital EHR data capture and sharing. Stage 2 is aimed at advancing clinical processes through the EHR, while Stage 3 is aimed at improving outcomes.

The more specific goals of each stage as detailed on CMS website appear below. 

Stage 1: MU criteria focus on:	Stage 2: MU criteria focus on:	Stage 3: MU criteria focus on:
Electronically capturing health information in a standardized format	More rigorous health information exchange (HIE)	Improving quality, safety, and efficiency, leading to improved health outcomes
Using that information to track key clinical conditions	Increased requirements for e-prescribing and incorporating lab results	Decision support for national high-priority conditions
Communicating that information  for care coordination processes	Electronic transmission of patient care summaries across multiple settings	Patient access to self-management tools
Initiating the reporting of clinical quality measures and public health information	More patient-controlled data	Access to comprehensive patient data through patient-centered HIE
Using information to engage patients and their families in their care		Improving population health

Anita Karcz, MD is the Chief Medical Officer at IHM Services