Faith At Law, LLC

16 Willow Avenue
Towson, Maryland 21286
(410) 963-5269
e: Email Us

Existing Client Login
Secure Site Admin
Subscribe to Our Newsletter
Unsubscribe
Admin Section

  Follow My Blog








Visit DirectLawConnect

Disaster Recovery Preparedness

Additional Resources

Meaningful Use and the EHR Contract Landscape

Hello all health care providers!  The Centers for Medicare and Medicaid (CMS) and the Department of Health and Human Services (HHS) have published a rather lengthy rule to define the phrase “meaningful use” in the context of the American Recovery and Reinvestment Act of 2009 (ARRA) and those Medicare and Medicaid incentives for providers that adopt an electronic health record (EHR) system.  (The rules are available here).  The published rule is currently in its comments phase, which means that it will not become final until CMS has received all public comments, considered them, and potentially made some changes to the requirements.  However, for those of you shopping for system now, a better understanding the rules in draft form will help you make a better decision with your prospective EHR vendors.  EHR vendors that are not presently certified by any certification agency (like CCHIT), and that cannot demonstrate their compliance with the Stage 1 requirements (described below) may not be the vendor for you.

Further, now is the time to take a sterner look at the contracts with EHR vendors, and it may be the time to negotiate into these contracts duties on the EHR vendors to help you, the provider, demonstrate meaningful use to the Secretary of HHS.  Otherwise, you run the risk of being unable to collect on the incentive payments under ARRA, but will still owe your EHR vendor for the licensing and related expenses.

The meaningful use regulations provide for three stages of demonstrating “meaningful use,” and provide specifics on Stage 1 in sections 495.6(c) and (d).  Here is the short list of requirements:

(c)(1) drug interaction checking

(c)(2) problem list

(c)(3) active medication list

(c)(4) active allergy list

(c)(5) basic patient demographics

(c)(6) record basic height, weight, blood pressure, BMI, and peds growth charts

(c)(7) smoking status

(c)(8) store lab results in structured data format

(c)(9) be able to produce a list of patients by disease condition

(c)(10) implement 5 clinical decision support rules based on provider specialty or priority

(c)(11) use electronic insurance eligibility

(c)(12) submit claims electronically

(c)(13) perform a medication “reconciliation”

(c)(14) provide a summary of care record for each referral, or “transition of care”

(c)(15) capacity to submit data to immunization registries

(c)(16) capacity to submit electronic surveillance data to public health agencies

(c)(17) comply with HIPAA security regs via risk assessment and mitigations

(d)(1) use “computerized provider order entry”

(d)(2) send prescriptions electronically

(d)(3) report ambulatory quality measures to CMS

(d)(4) send patient reminders for preventive care

(d)(5) provide patients with electronic health record data on request

(d)(6) provide patients with timely electronic access to their health data

(d)(7) provide each patient a clinical summary at each visit

(d)(8) exchange data with HIE’s

Along with the requirements are specific measures for demonstrating compliance (such as that interaction checking for drugs is active in the system, or in 80% of office visits, a drug reconciliation is performed).  Helpfully, the regulations provide a summary table of these requirements and measures starting on page 103.  A quick glance at this list should inform you at least that these requirements are substantial, and some may be quite challenging to implement.  In some cases, third party software or a software integrator (or both) will need to assist you beyond the EHR vendor in order to achieve these Stage 1 goals.

Prospective EHR vendors should be able to show you how they will aid you in complying with these requirements, and a reputable EHR vendor should be willing to put its compliance efforts in writing.  If you already have an EHR vendor that you use today, now is the time to start the conversation on compliance with these requirements.  Expect more news on this very important regulatory topic soon.