What’s Meaningful About Meaningful Use?

As of 2011, about 57% of providers in the United States were using some sort of EHR/EMR system in their office-based practice, but only 33% were using a system meeting basic requirements and even fewer had a fully functional system with advantages needed to fully aid healthcare.  The HITECH act set out payment scenarios allowing for (Medicare/Medicaid) payments to healthcare providers who demonstrate that they are “Meaningful EHR Users.” But what constitutes meaningful usage of an EHR? And perhaps more importantly, how does it allow a healthcare provider to offer better, more cost-effective healthcare?

Many of the requirements in stage 1 are simple; asking the providers to ensure data collection is complete and accurate. But stage 2 also raises the bar on the percentage of successfully reaching stage 1 goals. This includes confirming that allergies and active medications are accurate and up to date, doubling the number of electronic prescriptions (to 60%) as well as requiring some (30%) electronic ordering of lab and radiology tests. If these things are done, the EHR can ensure that new medications do not conflict with existing medications. A good EHR system will contain reminders and checks to make sure that not only are the proper procedures being followed, but also that nothing is being left out on each visit and that new orders, problems, and prescriptions are not repeated elsewhere in the record.

From the providers’ point of view, using an EHR to keep track of medications and allergies should ultimately provide a more accurate and easier way of keeping up to date with this clinically important information. But it also is important from the payers’ point of view because adverse drug effects (ADE’s) are considered both a significant, and costly, cause of hospitalizations and re-hospitalizations as well as, according to the Institute of Medicine, (IOM) a leading cause of morbidity and mortality. According to a recent IOM report, ADE’s harm 1.5 million people each year and can add up to $3.5 billion in costs each year. Some of these errors are due to bad handwriting, ignorance of drug interactions or lack of a full list of what the patient is taking. This is why electronic prescriptions and medication tracking are such an important part of MU and why the government is interested in paying for adherence to this requirement.

Therefore it becomes clear that using an EHR meaningfully means doing such things as ensuring that the record is kept completely up to date upon every visit, making sure there are no changes, and that the patient is not in danger of medical problems that can be avoided by keeping every record accurate and up to date. It may seem unnecessary to some, but in reality, it represents a momentary task that goes a long way towards ensuring proper and consistent payments for healthcare provided.

Further Reading:

IOM Report: “Health IT and Patient Safety”

Health Affairs: “A Survey Of Primary Care Doctors In Ten Countries Shows Progress In Use Of Health Information Technology, Less In Other Areas”

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